Specialties Cardiac
Published Jan 14, 2006
suzy0610
3 Posts
I am a new nurse. What do you do if someone is in a unstable rhythm?
SFCardiacRN
762 Posts
Need more info!
austin heart, BSN, RN
321 Posts
There are several unstable rhythms and they all have different treatments. Need more info.
Thunderwolf, MSN, RN
3 Articles; 6,621 Posts
Moving thread to Cardiac Nursing forum.
Angels'
288 Posts
Welcome to the All Nurses Forums.
:) I wish you the best in your nursing career. :)
A Pre-Nursing Student,
Angels’
"Footsteps In The Sand"
zacarias, ASN, RN
1,338 Posts
If it's not life-threatening at that moment, I would get a set of vitals and ask the patient how they are doing...of course the next step depends on what they say and what rhythm they are in.
chadash
1,429 Posts
When you are talking about unstable rhythms, are you talking about a pt who is unstable and symptomatic because of the rhythm,
or rhythms that are likely to progress to something more nefarious....
don't understand the question....
Dinith88
720 Posts
YOu're confusing the people who're reading this post for lack of a clear question. Your title is 'potentially unstable rhythm' then in post you ask what to do if a pt is in an unstable rhythm.
1) If a patient is in a 'potentially unstable rhythm', you're inferring(sp?) the patient is in a 'bad' rhythm but remains stable (good blood pressure, etc.).
IN this case, you would get in touch with MD for orders (though an experienced nurse will know/anticipate what's coming in terms of orders and can execute them quickly(if they've not already done so...which is a touchy issue depending on where you are and who the doc is...)) The thing you must remember is that there are several 'potentially unstable rhythms' and you dont treat them all the same...
2)IF a patient IS in an unstable rhythm, it measns your patient is crashing and you must act quickly. ACLS guidlines are followed and the nurse can treat without(before) calling doc because time is of the essence and your patient may soon die. The key is getting/knowing/confidence in ACLS. If you are not acls, or patient is on floor where most nurses are not, then a code/rrt should be called quickly.
3) again, there're several varieties of 'unstable rhythms'...and if you treat them incorrectly you can actually make things worse.
Actually, I am confused on my own, it isn't your fault!
Ok, here's a thought, but you nurses need to straighten me out on this:
My son runs every day and has a resting pulse of about 55. Would that be stable bradycardia, or not bradycardia at all?
Now, my mom has CHF, and if her pulse drops to 55, we got trouble: dizziness, shortness of breathe and all that, now this is unstable bradycardia, right?
And then, you put some poor homeless guy on a monitor and he has torsades de pointes, and you know that one could take a nosedive to VF. Now that is an unstable rhythm, right?
Oh! I am so confused! Help me!
UM Review RN, ASN, RN
1 Article; 5,163 Posts
Ok, here's a thought, but you nurses need to straighten me out on this:My son runs every day and has a resting pulse of about 55. Would that be stable bradycardia, or not bradycardia at all?Now, my mom has CHF, and if her pulse drops to 55, we got trouble: dizziness, shortness of breathe and all that, now this is unstable bradycardia, right?And then, you put some poor homeless guy on a monitor and he has torsades de pointes, and you know that one could take a nosedive to VF. Now that is an unstable rhythm, right?Oh! I am so confused! Help me!
I'm no expert, but here's my take on these:
1. Your son is OK with a bradycardia because he's "athletic" and athletes typically have resting HR's of
2. Your mom is having symptomatic bradycardia and needs vitals taken as well as some form of treatment, yes. I'd call 911 on that one to get her treated ASAP.
3. If the poor homeless guy is having torsades to the monitor, I believe that our first action would be to give the man some Magnesium, per ACLS protocol, and of course, have the Code Cart right up close and personal, along with the Code Team.
I'm no expert, but here's my take on these:1. Your son is OK with a bradycardia because he's "athletic" and athletes typically have resting HR's of 2. Your mom is having symptomatic bradycardia and needs vitals taken as well as some form of treatment, yes. I'd call 911 on that one to get her treated ASAP.3. If the poor homeless guy is having torsades to the monitor, I believe that our first action would be to give the man some Magnesium, per ACLS protocol, and of course, have the Code Cart right up close and personal, along with the Code Team.
You're good...