Alyssa Carter is a 7 year old female who was born at 32 weeks gestation and was diagnosed with a Ventricular Septal Defe

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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 all immunizations. 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. In your initial post, please address the
following questions:
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 to be 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.