Case
NUR 463Hemodynamic Monitoring Case study
- Institution
- University Of Rhode Island
This is a comprehensive and detailed case study on Hemodynamic Monitoring for Nur 463. *Essential Study Material!!
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NUR 463 Hemodynamic Monitoring Case studyName:
Date: September 27, 2017
Mrs. M., a 61-year-old female, is admitted to the critical care unit after emergency surgery for
treatment of a perforated bowel. Intraoperatively she had an estimated blood loss of 300 mL, and
she received 2.5 L of crystalloid solution. An arterial line, subclavian triple-lumen catheter, and
indwelling urinary catheter are placed in the operating room. Upon admission to the critical care
unit, Mrs. M. is intubated and sedated. She is placed on mechanical ventilation with the following
settings: assist/control mode at 12 breaths/min; tidal volume, 650 mL; fraction of inspired oxygen,
1.0 (100%); and positive end-expiratory pressure, 5 cm H2O. Her initial postoperative vital signs
and laboratory findings are:
Heart rate 140 beats/min
Blood pressure 88/49 mm Hg
Mean arterial pressure 62 mm Hg
Respiratory rate 12 breaths/min
Right atrial pressure 4 mm Hg
Temperature 39.2 C (102.6° F)
Lactate 1.1 mEq/L
The physician orders a 500-mL infusion of normal saline (NS) 0.9%, repeat of serum lactate level,
and replacement of the triple-lumen catheter with a catheter that measures ScvO2. The nurse
administers the fluids and assists with the placement of the ScvO2 catheter. After these
interventions, the nurse reassesses vital signs and hemodynamic values, which are noted below:
Heart rate 118 beats/min
Blood pressure 96/52 mm Hg
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