Question....

[mountainnurse]

Hi, I am new to this site and have encountered a question that I can't seem to find a definitive answer to. I am a second year nursing student and have been asked to prioritize care of four patients with abnormal cardiac rhythms. We have not been given any information about the diagnosis, symptoms, or anything additional besides these four criteria.

Ventricular fibrillation (1)

A-fib (2)

sinus brady (?)

sinus tachy (?)

The first two are obvious to me, but with such little information it is difficult for me to make an assessment on which of these two rhythms requires my attention first. Any suggestions would be greatly appreciated.

Thanks!!!

[bargainhound, RN]

Symptomatic sinus brady would be number 2 I would think.

[mountainnurse]

We haven't been told whether or not they are symptomatic, would you still assess this over A fib?

[KIAN]

That is a great question. It really makes you critically think. Granted it would be much easier if we knew the symptoms. Otherwise let the debate begin. I think Vfib 1, A-fib 2 (due to the possibility of emboli), Sinus brady 3 because it can require more treatment than sinus tach -4. ( A good bowel movement could take care of sinus tach, you know the vagal maneuver.

IMHO.

[mountainnurse]

Thank you so much for your input!!! I was thinking the same thing because there is more that can be done to treat sinus brady, and pts in the hospital are under stress which can cause sinus tach without pathological causes. Does anyone have other thoughts, agree or disagree??