Reference no: EM133342425

Alyssa Carter is a 7 year old female who was born at 32 weeks gestation and was diagnosed with a Ventricular Septal Defect (VSD) at one year of age. Alyssa has been medically managed and has not required operative intervention. Her development matches her chronological age. She is in the second grade in a public elementary school. She is up to date on allimmunizations.

Alyssa presented to the emergency department twice over the past month with complaints of her "heart pounding". Each time she was assessed and sent home without intervention. Alyssa's mother brings her to the emergency department today again and reports that she was outside playing and came into the house complaining of her heart pounding and feeling like she had just gotten off the merry go round. The mom reports she was pale and sweaty. Her mother had her lie down on the sofa for 30 minutes, but the lightheadedness and pounding in her chest did not dissipate.

The nurse places Alyssa on the cardiac monitor and notes a regular, narrow, complex rhythm with a rate of 174.

1. What physical assessment findings will the nurse expect?

2. Describe the three priority interventions and the rationale for these interventions the nurse will perform.

3. The vagal maneuvers are not successful and the ED physician has ordered Adenosine tobe administered. Describe the pharmacologic action of Adenosine and the key nursing considerations of administering this medication.

4. Alyssa converts to an NSR at 90 beats per minute after two doses of adenosine. The physician discharges her with a prescription of oral digoxin. Develop patient/family medication education for Alyssa prior to discharge.