Before administering adenosine (Adenocard), which action is most critical for the nurse?

The most critical action for the nurse before administering adenosine (Adenocard) is to apply continuous cardiac monitoring. Adenosine is used primarily for the treatment of certain types of supraventricular tachycardia (SVT). Its administration can result in significant changes in heart rhythm, including transiently causing bradycardia or complete heart block. Continuous cardiac monitoring allows the healthcare team to observe these changes in real time, ensuring that any potentially serious arrhythmias or adverse effects can be promptly identified and managed.

Establishing appropriate cardiac monitoring is essential in a clinical setting where adenosine is administered, as it helps to assess the drug's efficacy and to ensure patient safety throughout the process. Additionally, continuous monitoring can provide instantaneous feedback on the patient's cardiovascular status, which is critical during the administration of medications that impact heart rate and rhythm.

While other actions, such as informing the client about possible facial flushing, are important, they do not take precedence over the imperative need for monitoring heart rhythm. Educating the client and managing the environment are also relevant, but they do not address the immediate requirement to keep the patient’s heart response under surveillance during the administration of this potent medication.