What should the nurse do first if a patient develops bradycardia with PVCs while suctioning the ET tube?

When a patient develops bradycardia with premature ventricular contractions (PVCs) during the suctioning of an endotracheal (ET) tube, immediate action is critical to ensure the safety and stability of the patient. The first step should be to stop the suctioning process. Continuing to suction in this situation could exacerbate the patient's condition, as it can increase the patient's tension and potential hypoxia.

Ventilating the patient with a bag-valve mask using 100% oxygen serves two important purposes. First, it addresses any potential hypoxia and ensures the patient is receiving adequate oxygenation, which is vital when bradycardia and PVCs are present. Second, it helps to alleviate the hemodynamic effects caused by the decreased heart rate and abnormal rhythm by providing immediate respiratory support.

Using 100% oxygen helps to maximize oxygen delivery to the tissues, which is particularly essential when the cardiac output may be compromised due to bradycardia. Additionally, it offers time for the patient to recover from the vagal reflex or other causes of the decreased heart rate. This approach aligns with standard resuscitation protocols that prioritize ventilation and oxygenation, especially in cases where the patient's heart rate is irregular or concerning.

Therefore, stopping