When a cardiac monitor shows an erratic rhythm, what should the nurse do first?

In the scenario where a cardiac monitor displays an erratic rhythm, the priority action is to assess the client. This step is fundamental because it allows the nurse to evaluate the patient's clinical status and understand the potential implications of the observed rhythm. By assessing the client first, the nurse can identify any associated signs and symptoms, such as changes in vital signs, level of consciousness, or any other indicators of hemodynamic instability or distress.

This primary evaluation guides subsequent actions. For example, if the patient shows signs of hypotension or altered mental status, this may necessitate calling a code or initiating further interventions more urgently. By first assessing the client, the nurse ensures that patient safety is prioritized and that appropriate clinical decisions are made based on the individual’s overall condition rather than solely on the monitor's readout.

Other actions, such as checking the leads or obtaining a rhythm strip, are also critical steps in managing a monitor with an erratic rhythm, but they come after the initial assessment of the patient’s condition. These steps might help clarify the situation further, but they do not replace the need to first understand the direct impact of the erratic rhythm on the patient’s health. Therefore, assessing the client is the appropriate first response in this scenario.