A client with atrial fibrillation is scheduled for an elective cardioversion. Which action is most important before deploying the current?

• A. Activate the synchronization mode
• B. Check blood glucose
• C. Remove all jewelry
• D. Administer rapid-acting insulin

Answer: (A)

Before delivering a shock for cardioversion, the device must be set to synchronized mode so the energy is timed to the R wave on the ECG. This ensures the shock is delivered at the correct moment in the cardiac cycle, reducing the risk of shocking during the vulnerable repolarization phase and potentially triggering ventricular fibrillation. Synchronization uses the patient’s ECG to trigger the shock only at the moment of ventricular depolarization, making the procedure safe and effective for restoring normal rhythm. Other steps, like removing jewelry for safety or checking unrelated factors such as blood glucose, are important safety and overall care considerations, but they do not address the immediate risk of inducing a dangerous arrhythmia during the shock.