A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily.
B. Inhale deeply and cough forcefully every 1 to 3 seconds.
C. Lie down flat in bed.
D. Remove any metal jewelry.
Correct Answer: B. Inhale deeply and cough forcefully every 1 to 3 seconds.
Cough Cardiopulmonary Resuscitation (CPR) sometimes is used in the client with unstable ventricular tachycardia. The nurse tells the client to use cough CPR, if prescribed, by inhaling deeply and coughing forcefully every 1 to 3 seconds. Cough CPR may terminate the dysrhythmia or sustain the cerebral and coronary circulation for a short time until other measures can be implemented. A nurse or physician can instruct and coach the patients to cough forcefully every one to three seconds during the initial seconds of a sudden arrhythmia. But because it’s not effective in all patients, it shouldn’t delay definitive treatment.
Option A: Asymptomatic patients with non-sustained ventricular tachycardia (VT) and no underlying cardiac comorbidities require no additional therapy. Patients that are symptomatic and without cardiac comorbidities should be started on a beta-blocker due to favorable efficacy and safety profile.
Option C: If these patients continue to have episodes of non-sustained VT despite beta-blocker therapy, or cannot tolerate beta-blocker therapy, a calcium channel with atrioventricular nodal action such as verapamil or diltiazem can be used.
Option D: Patients with sustained monomorphic ventricular tachycardia (SMVT) that are unstable should be managed following advanced cardiac life support (ACLS) guidelines. Hemodynamically stable patients should be pharmacologically cardioverted using an antiarrhythmic medication. Intravenous amiodarone or procainamide can be used for this purpose.
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