What action should the nurse take first when using an AED on an unresponsive and pulseless person?

When using an AED (Automated External Defibrillator) on an unresponsive and pulseless person, the first action to take is to remove medication patches on the chest. This is vital because medication patches can interfere with the delivery of the electrical shocks essential for defibrillation. These patches may contain conductive materials like aluminum or other substances that could create a pathway for electrical current, potentially causing burns to the skin or impairing the shock's effectiveness.

By ensuring the chest is free from any obstructions, including medication patches, the nurse helps maximize the safety and efficacy of the defibrillation process. It is also important to ensure that the skin surface is clean and dry for optimal pad adhesion and conductivity, but the immediate concern is the presence of medication patches that pose a risk during shock administration. Therefore, the correct first action focuses on assessing and preparing the area where the AED pads will be applied, ensuring the best chance of restoring a normal heart rhythm.