A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?

Choice a) is incorrect because morphine sulfate is an appropriate prescription for a client who has acute heart failure following MI. Morphine sulfate is an opioid analgesic that can relieve pain, anxiety, and dyspnea. Morphine sulfate can also reduce the preload and afterload of the heart, which can improve the cardiac output and oxygenation.

Choice b) is incorrect because laboratory testing of serum potassium is an appropriate prescription for a client who has acute heart failure following MI. Serum potassium is an electrolyte that is important for the normal function of the cardiac cells and muscles. Serum potassium can be altered by various factors, such as renal function, acid-base balance, medications, or dietary intake. Serum potassium can affect the cardiac rhythm and contractility, which can influence the outcome of the client.

Choice c) is correct because 0.9% normal saline IV at 50 mL/hr continuous is a prescription that requires clarification for a client who has acute heart failure following MI. 0.9% normal saline is an isotonic solution that can maintain the fluid balance and blood pressure in the body. However, 0.9% normal saline can also cause fluid overload and worsen the heart failure symptoms, such as edema, crackles, and dyspnea. The nurse should clarify with the provider if this prescription is appropriate for the client's condition and if there are any parameters or limits for the fluid administration.

Choice d) is incorrect because bumetanide 1 mg IV bolus every 12 hr is an appropriate prescription for a client who has acute heart failure following MI. Bumetanide is a loop diuretic that can increase the urine output and reduce the fluid volume and pressure in the body. Bumetanide can also decrease the preload and afterload of the heart, which can improve the cardiac output and oxygenation.

Choice A: Inspecting the electrode pads is an action that the nurse should take. The electrode pads are adhesive patches that atach to the skin and connect to the ECG machine. The nurse should inspect the electrode pads for expiration date, cleanliness, and stickiness, and replace them if necessary. The nurse should also check for any signs of skin irritation or allergy from the electrode pads.

Choice B: Instructing the client not to talk during the test is an action that the nurse should take. Talking during the test can interfere with the ECG recording and cause artifacts or false readings. The nurse should instruct the client to remain still and quiet during the test, and avoid any movements or activities that can affect the heart rate or rhythm, such as coughing, deep breathing, or shivering.

Choice C: Administering an analgesic prior to the procedure is not an action that the nurse should take. An analgesic is a pain reliever that can be given orally, intravenously, or topically. An analgesic is not necessary for an ECG, as it is a noninvasive and painless procedure. An analgesic can also alter the heart rate or rhythm and affect the ECG results. The nurse should only administer an analgesic if prescribed by the provider for another reason.

Choice D:It is more common to use alcohol swabs, and not water, to clean the skin as they are better at removing oils and ensuring good adhesion of the electrodes.

Choice E: Keeping the client NPO after midnight is not an action that the nurse should take. NPO means nothing by mouth, which is a restriction of food and fluids before certain procedures or surgeries. NPO is not required for an ECG, as it does not involve any anesthesia or sedation. The nurse should allow the client to eat and drink normally before and after the test, unless instructed otherwise by the provider.