# A stable client has a regular narrow-complex tachycardia that persists after vagal maneuvers. Place the nursing actions in order.

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> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A stable client has a regular narrow-complex tachycardia that persists after vagal maneuvers. Place the nursing actions in order.

Observe the continuous rhythm strip, symptoms, blood pressure, and response.

Administer the prescribed first adenosine dose by rapid IV push.

Verify continuous ECG, blood pressure monitoring, IV patency, rhythm regularity, and resuscitation readiness.

If the rhythm persists, prepare the authorized next step or second dose while reassessing stability.

Immediately follow the medication with the ordered rapid normal-saline flush.

## Explanation

After confirming a stable regular rhythm and monitoring readiness, adenosine is given by rapid IV push followed immediately by saline, then the response and need for the next step are assessed.

## In-depth explanation

Quick answer
Use the sequence verify, rapid push, immediate flush, observe, reassess.

Why this is correct
Adenosine has an extremely short half-life, so the rapid push and immediate saline flush form one administration event. Continuous rhythm and hemodynamic monitoring show the diagnostic and therapeutic response.

Easy analogy or mental picture
The medication is a very short message; the flush carries it quickly to the heart before it disappears.

Memory hook
Adenosine: ready, push, flush, watch, reassess.

NCLEX decision rule
Confirm stability and regularity before using the narrow-complex adenosine pathway.

Why the other choices are wrong
A slow infusion, delayed flush, or failure to reassess can make the dose ineffective or miss deterioration.References
1AHA 2025 Adult Tachyarrhythmia With a Pulse AlgorithmInitial support, regular narrow-complex pathway, rapid adenosine administration, flush, and rhythm reassessment

## Clinical scenario

Adenosine sequence
Document rhythm width and regularity, stability, vagal response, IV site, dose and flush time, rhythm strip, symptoms, pressure, and next-step authorization.

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