Which is a shockable rhythm?

JIPMER Pondicherry NO - 2022

Medical Surgical Nursing

Easy

Appeared in: JIPMER Pondicherry NO - 2022

Explanation

Ventricular fibrillation (VF) is a life-threatening arrhythmia where the ventricles quiver chaotically instead of contracting effectively.
This chaotic electrical activity prevents the heart from pumping blood, resulting in cardiac arrest.
It is classified as a 'shockable' rhythm because an electrical shock (defibrillation) can depolarize the entire myocardium at once, stopping the chaos and allowing the heart's natural pacemaker to potentially resume a normal rhythm.
Pulseless Ventricular Tachycardia (pVT) is the other primary shockable rhythm.

Option A: Asystole, also known as 'flatline', represents the complete absence of ventricular electrical activity. A defibrillator shock is ineffective because there is no underlying electrical rhythm to reset.
Option B: In Pulseless Electrical Activity (PEA), the ECG shows organized electrical activity, but there is no mechanical contraction of the heart and therefore no palpable pulse. Since the problem is mechanical failure (electromechanical dissociation) rather than electrical chaos, a shock provides no benefit.
Option D: This option is incorrect because a valid shockable rhythm, Ventricular Fibrillation, is listed as option C.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of cardiac arrest rhythms (shockable vs. non-shockable) as background academic context rather than a clinical decision trigger.
Rapid and accurate rhythm identification is a critical nursing skill during a 'code blue' situation, as it dictates the immediate life-saving intervention according to ACLS algorithms (shock vs. no shock).
For shockable rhythms (VF/pVT), the priority is 'early defibrillation saves lives.' For non-shockable rhythms (Asystole/PEA), the focus is on 'high-quality CPR and medications' while searching for a cause.
What if? If the patient had a pulse but the monitor showed Ventricular Tachycardia (V-Tach), the patient is considered unstable but not in cardiac arrest. The treatment for unstable V-Tach with a pulse is synchronized cardioversion, not defibrillation, which is an unsynchronized shock.

How to Approach the Question

First, identify the core of the question: it asks to identify a 'shockable rhythm'.
This is a factual recall question based on Advanced Cardiac Life Support (ACLS) protocols.
Recall the two main categories of cardiac arrest rhythms: shockable and non-shockable.
The two shockable rhythms are Ventricular Fibrillation (VF) and pulseless Ventricular Tachycardia (pVT).
The two non-shockable rhythms are Asystole and Pulseless Electrical Activity (PEA).
Scan the given options to find which one fits into the 'shockable' category.

Concept Tested & Keywords

Concept Tested: Classification of cardiac arrest rhythms (shockable vs. non-shockable).
Stem keywords: shockable rhythm
Lead-in keywords: Which is
Negative lead-in flag: false

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