03.10 Ventricular Fibrillation (V Fib)

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Overview

  1. Ventricular Fibrillation
    1. Multiple unorganized electrical signals in the ventricles
      1. Causing the ventricles to quiver
        1. Wavy lines
      2. Heart not able to pump blood out
        1. Zero cardiac output
      3. Life threatening emergency
        1. Cardiac arrest

Nursing Points

General

  1. Characteristics of Ventricular fibrillation
    1. Rhythm
      1. Irregular
    2. Rate
      1. Not measurable
    3. P:QRS ratio
      1. Not measurable
    4. PR interval
      1. Not measurable
    5. QRS complex
      1. Not measurable

Assessment

  1. Patient Presentation
    1. Cardiac arrest
    2. Will NEVER have a pulse!

Therapeutic Management

  1. Nursing Interventions
    1. CPR
  2. Follow ACLS guidelines
    1. CPR
    2. Defibrillate
    3. Epinephrine
    4. Amiodarone

Nursing Concepts

  1. EKG Rhythms
  2. Perfusion

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Video Transcript

So in this lesson we are going to talk about ventricular Fibrillation or V-Fib. It is a very important rhythm to understand because patients in V-fib are in cardiac arrest and we need to do something immediately or they will die! When you see this rhythm, they will go asystole if we don’t treat it. So let’s talk about V-fib.

So in ventricular fibrillation the ventricles are quivering and absolutely no cardiac output there is usually no pulse. So since the ventricles are just sitting there quivering, they are not contracting, there is absolutely no cardiac output and no pulse. So CPR must be initiated immediately. This rhythm is very common in patients that are having a heart attack or have severe coronary artery disease. If left untreated, people will go into asystole and just die. Let’s talk about the characteristics for v-fib.

It’s pretty simple to do cause there is not much to it! The rhythm is irregular, remember the heart is erratically quivering, there is no way to measure a heart rate, there are no P waves so there is not a P to QRS ratio, the PR interval is not measurable and you cannot really count the QRS complex. There is no QRS complex since the heart is just quivering it is not measurable. In step 6, it is obviously V-fib. It is one of those rhythms that you need to make a jump for it and you need to prepare to start CPR, bring the defibrillator and call a code.

So people in V-fib have no cardiac output they are in cardiac arrest, they are dying! The priority nursing interventions are to follow the ACLS guidelines, confirm there is not a pulse and start CPR right away. Defibrillate as soon as possible, it is the only chance they have of going into a normal sinus rhythm. Epinephrine every 3-5 minutes and then Amiodarone bolus and drip. However early defibrillation is the best treatment. So as soon as you see this rhythm, you start CPR, call a code, defibrillate them and give meds and hopefully you will bring the patients back.

So the key points to remember from this lesson are the abnormalities regarding Ventricular fibrillation. The ventricles are quivering and fibrillating, there is no cardiac output so the patients in V-fib are in cardiac arrest. Nursing interventions are to follow the ACLS guidelines immediately and start CPR, defibrillate asap and administer medications. This cycle is repeated every 2 minutes or until the code is called and CPR is terminated or hopefully the patient has regained a pulse. V-fib is not one of those rhythms that you wait to see if this is really happening, you need to take action right away!

I hope you guys have enjoyed this quick lesson regarding V-Fib and feel more comfortable knowing what to do when you see this rhythm. Make sure you check out all of the resources attached to this lesson. Now, go out and be your best self today! And, as always, happy nursing!

Read more

  • Question 1 of 10

A client has gone into ventricular fibrillation. Two nurses run into the room and one nurse tries unsuccessfully to find a pulse. The other nurse immediately begins CPR while the first nurse calls a code and grabs the ambu bag. What is the most important aspect of this attempted resuscitation?

  • Question 2 of 10

A new nurse is reviewing a rhythm on a telemetry monitor and believes it might be ventricular fibrillation. Which of the following characteristics is the nurse most likely observing? Select all that apply.

  • Question 3 of 10

The nurse is caring for a client whose EKG (ECG) results have just been obtained. The nurse recognizes which of the following rhythms as an emergency?

  • Question 4 of 10

A new nurse observes the following rhythm and interprets it as which of the following?

  • Question 5 of 10

A 67-year-old client is brought into the emergency room for treatment of a possible myocardial infarction. The nurse places ECG leads on the client’s chest to check his cardiac rhythm. The client initially demonstrates sinus tachycardia but then rapidly transitions into ventricular fibrillation. Which best describes the heart rate associated with ventricular fibrillation?

  • Question 6 of 10

A new nurse notices what appears to be ventricular fibrillation (V-fib) on the monitor and quickly enters the client’s room to find the client sitting on the side of the bed talking. After the nurse checks the pulse and determines the client has a regular pulse of 85 beats per minute the nurse should do which of the following next?

  • Question 7 of 10

The student nurse is discussing ventricular fibrillation with their nursing instructor, the student nurse needs further teaching after which of the following statements about ventricular fibrillation (V-fib) is made?

  • Question 8 of 10

The nurse is looking at the central cardiac monitor for clients on a telemetry unit. Which EKG (ECG) rhythm is a priority and needs to be addressed immediately?

  • Question 9 of 10

The nurse is caring for a client who has suddenly gone into ventricular fibrillation. Which of the following is true about this condition? Select all that apply.

  • Question 10 of 10

The nurse responds to a code for a client in ventricular fibrillation. Which of the following interventions does the nurse anticipate for this situation? Select all that apply.