Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the appropriate next intervention for a patient in respiratory distress with an unstable blood pressure reading?

1. Defibrillation

2. Synchronized cardioversion

3. Intubation

4. Oxygen supplementation

The correct answer is: Synchronized cardioversion

In a scenario where a patient is experiencing respiratory distress and unstable blood pressure, the primary concern is to stabilize the patient's respiratory function and manage their hemodynamics effectively. When considering intervention, providing adequate oxygenation is crucial. Oxygen supplementation is a fundamental intervention for a patient in respiratory distress because it directly addresses the key problem of hypoxemia. By improving oxygen delivery to tissues, oxygen supplementation can help relieve some of the stress on the cardiovascular and respiratory systems. This intervention is typically implemented before more invasive procedures like intubation, which may not always be the first step depending on the patient's overall condition and responsiveness. In this context, intubation might be warranted if the patient's airway is compromised or if ventilatory support is urgently needed, but the immediate action would usually involve supplemental oxygen unless there are specific considerations that necessitate intubation right away. Techniques such as defibrillation and synchronized cardioversion are more appropriate for arrhythmias, not directly for respiratory distress or unstable blood pressure unless the heart rhythm changes warrant immediate action. Therefore, the most appropriate initial intervention in this situation would be oxygen supplementation to stabilize the patient's oxygen levels while simultaneously addressing the blood pressure instability.