Medical-surgical Nursing Demystified

(Michael S) #1

CHAPTER 1 Cardiovascular System^57



  • Lab work—CBC, electrolytes, drug levels, coagulation studies.

  • No atrial or ventricular rhythm on the electrocardiogram.


TREATMENT


Treatment consists of restarting the heart and, when that has occurred, determin-
ing the cause of the asystole. Basic Life Support (CPR) should optimally be started
within two minutes (once asystole is established, CPR should be initiated imme-
diately when asystole is detected, and Advanced Cardiac Life Support within eight
minutes.



  • Cardiopulmonary resuscitation.

  • Advanced Cardiac Life Support.

  • Oxygen.

  • Start IVs to maintain access.

  • Transcutaneous pacing, where electrodes are placed on the front and back of
    the chest while high current is delivered to the patient to pace the ventricles.

  • Endotracheal intubation.

  • Administer buffering agent to correct acidosis:

    • sodium bicarbonate



  • Administer antiarrhythmics to control arrhythmia:

    • atropine

    • epinephrine




NURSING DIAGNOSES



  • Impaired gas exchange

  • Decreased cardiac output

  • Ineffective tissue perfusion


NURSING INTERVENTION



  • Begin CPR.

  • Prepare to administer medication per physician’s order or protocol.

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