The nurse is caring for a patient with acute inferior
wall MI, post-coronary artery stent deployment,
For optimal care of the patient, the nurse should: -
answer Continuously monitor the patient in lead II
It is best practice to monitor the patient status
post PCI with stent, in the lead that was most
abnormal during the acute occlusion.
The ECG demonstrates ST elevation in leads II, III
and aVF. The nurse needs to monitor the patient
closely for which of the following? - answer
Complication likely to occur after an acute inferior
wall MI include bradycardia secondary to ischemia
to the SA and/or AV node, and papillary muscle
rupture or dysfunction due to the anatomical
distance between the RCA and the papillary
muscle.
Which of the following hemodynamic profiles would
benefit from the aggressive fluid administration,
pressers and antibiotics therapy?
b. RAP: 5; PAOP: 7; SVR: 400; CO; 8L - answer B.
the hemodynamic profile of RAP 5, PAOP 7, SVR
400 is typical of septic shock, and choice B would
be the best approach.
Which of the following is indicative of a mixed acid-
base disorder?
A. pH 7.18; PaCO2 25; PaO2 64; HCO3 11
B. pH 7.33; PaCO2 29; PaO2 72; HCO3 15 - answer
The decrease in PaCO2 is evidence of respiratory
alkalosis and the decreased HCO3 is evidenced of a
metabolic acidosis. The pt with severe sepsis or
septic shock may present with this mixed acid-base
disorder.
The patient with a temporary pacemaker develops
pacemaker malfunction. The oriented is instructed
to reposition the patient to try and correct the
problem. The cardiac monitor most likely
demonstrates? - answer Failure to capture
(pacemaker without a QRS) may be corrected by
repositioning the patient to the side.
,The patient with diastolic heart develops SVT,
heart rate 220/min. The most dangerous
hemodynamic effect is a decrease in: - answer
coronary artery perfusion.
Diastolic heart failure results in a problem with left
ventricular FILLING secondary to ventricular
thickening, and contractility and ejection are
maintained in diastolic failure. The rapid heart rate
will decrease filling time, worsen left ventricular
filling and because coronary artery perfusion
occurs during diastole, this arrhythmia may be life-
threatening.
The patient is receiving heparin infusion for the
treatment of pulmonary embolism. There has been
a 60% decrease in the platelet count and no clinical
change. Which of the following is indicated? -
answer Discontinue heparin and being
argatroban.
The patient most likely has HIT. Exposure to
heparin needs to discontinued and a direct
thrombin inhibitor started for continued
anticoagulation.
, The patient with oat cell carcinoma has the
following clinical findings: low urine output, low
serum osmolality, hyponatremia, and elevated
urine sodium. The nurse anticipates which of the
following as part of the treatment plan? - answer
Phenytoin (Dilantin), 3% saline.
The patient has signs of SIADH which results in
production of excessive ADH. Dilantin will inhibit
ADH secretion and 3% saline will increase serum
sodium.
Peep therapy and mechanical ventilation are
ordered for the patient with acute respiratory
failure. Which of the following is a possible
complication? - answer Barotrauma
The addition of positive end-expiratory pressure
will increase alveolar recruitment, prevent
atelectasis and improve oxygenation. However, the
increase in intrathoracic pressure may lead to
pneumothorax or subcutaneous emphysema.
The postoperative thoracic surgery patient has
bubbling in the water seal drainage chamber of the
chest tube. Which of the following interventions is
indicated? - answer avoid high airway pressures
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