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Hesi RN Complex Adult Health II (A+ Graded
Already) 2024
Indication for arterial line placement? correct answers Hemodynamic monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
What test must be preformed prior to an arterial line placement? correct answers Allen's test
How often should a fast flush test be preformed? correct answers Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? correct answers Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: correct answers 30-60 degrees of dorsiflexion with the aid of a roll of gauze and an armband.
Avoid hyperabduction of the thumb.
How often should the atrial line catheter be changed out? correct answers Every 7 days
Causes of inaccuracy in arterial line readings: correct answers Air bubbles in the catheter system
Failure to zero the transducer air-fluid interface
Blood in the catheter system
Blood clot at the catheter tip
Kinking of the tubing system
Catheter tip lodging against the arterial wall
Soft, compliant tubing
Long tubing
Too many stopckcks (>3)
What is the pathology of afterload? correct answers The pressure in which the heart must pump against in order to eject blood during systole.
Medications that reduce afterload/preload include? correct answers Vasodilators
What is the pathology of preload? correct answers The filling pressure of the heart at end of diastole.
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What is systemic vascular resistance (SVR)? correct answers Resistance the left ventricle must overcome to open the aortic valve and eject a volume of blood into systemic circulation.
Systemic vascular resistance (SVR) is used for what calculations? correct answers Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? correct answers Resistacne the right ventricle must overcome to open the pulmonic valve and eject a volume of blood in the pulmonary vasculature.
What is pulmonarartery occlusion pressure (PAOP)? correct answers The pressure created by the
volume of blood that remains in the left heart at end-diastole.
Inotropic drugs mode of action: correct answers Negative inotropic drugs weaken the force of muscular contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: correct answers Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: correct answers Relaxes the smooth muscles of the blood vessels opening them up.
Vasodilator drug examples: correct answers CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
Lisinopril (Prinivil, Zestril)
Kayexalate correct answers Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate correct answers Prevents and treats cardiac toxicity related to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)? correct answers Dialysis
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This is a blood filtering therapy that replaced the normal blood-filtering function of the kidneys in patients with renal failure and acute kidney injuries.
The prerenal system correct answers Delivers blood to the kidneys.
A prerenal block is: correct answers An interruption on the way to the kidneys.
The intrarenal system correct answers Processes ultra-filtrate by tubular secretion & re-
absorption.
An intrarenal block is: correct answers Direct damage to the kidneys.
The postrenal system correct answers Excretes kidney waste products through the ureters, bladder, and urethra.
A postrenal block is: correct answers Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): correct answers <400 mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): correct answers Urine output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): correct answers Cr >1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
S/SX of the injury stage of acute kidney injury (AKI): correct answers Cr >2xbaseline
Urine output <0.5ml/kg/hr for 12+ hours
S/SX of the risk failure of acute kidney injury (AKI): correct answers Cr >3xbaseline
Urine output <0.3ml/kg/hr for 12+ hours
Priority assessment findings of acute kidney injury (AKI): correct answers Respiratory:
Crackles
Pleural Effusion
Kussmaul respirations
Cardiovascular:
CHF, hypo/hypertension
Cardiac dysrhythmias
Pericarditis, pericardial effusion
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