A client with stable regular narrow-complex supraventricular tachycardia is prescribed IV adenosine after vagal maneuvers fail. Which action should the nurse take?
1Dilute the adenosine in 100 mL of saline, infuse it over 30 minutes, and record the rhythm afterward.
2Give adenosine rapidly through a proximal IV, follow immediately with saline, and monitor the ECG continuously.✓ Correct answer
3Inject adenosine intramuscularly, check the blood pressure in 5 minutes, and repeat the dose if needed.
4Give adenosine through a distal IV over 2 minutes, then disconnect monitoring while the client rests.
Explanation
Adenosine has an extremely short half-life, so it should be administered as a rapid IV push through a proximal line and followed immediately by a rapid saline flush while continuous ECG monitoring and resuscitation capability are available. A slow infusion, intramuscular injection, or delayed distal administration may not deliver an effective concentration to the heart. Monitoring should remain in place because transient rhythm changes and symptoms can occur.
Clinical reasoning summary Adenosine must reach the heart before it is rapidly metabolized. Use a proximal IV, give the prescribed dose as a rapid push, flush immediately with saline, and maintain continuous ECG and emergency readiness.