Potentially unstable rhythms

Specialties Cardiac

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I am a new nurse. What do you do if someone is in a unstable rhythm?

:uhoh3:

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Need more info!

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Specializes in ICU.

There are several unstable rhythms and they all have different treatments. Need more info.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Moving thread to Cardiac Nursing forum.

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suzy0610

Welcome to the All Nurses Forums.

:) I wish you the best in your nursing career. :)

A Pre-Nursing Student,

Angels’

"Footsteps In The Sand"

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Specializes in tele, stepdown/PCU, med/surg.

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.

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Specializes in Nursing assistant.

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....

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Specializes in CCU/CVU/ICU.
I am a new nurse. What do you do if someone is in a unstable rhythm?

:uhoh3:

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.

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Specializes in Nursing assistant.
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.

Actually, I am confused on my own, it isn't your fault!:coollook:

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Specializes in Nursing assistant.

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!

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Specializes in Utilization Management.
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.

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Specializes in Nursing assistant.
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...

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