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TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSING 8TH EDITION BY MARY LOU SOLE; DEBORAH GOLDENBERG KLEIN; MARTHE J. MOSELEY | 2021/2022 | 9780323641937| CHAPTER 1-21 QUESTIONS AND COMPLETE WELL EXPLAINED 100% CORRECT ANSWERS WITH RATIONALES ALREADY PAS$8.34
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TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSING 8TH EDITION BY MARY LOU SOLE; DEBORAH GOLDENBERG KLEIN; MARTHE J. MOSELEY | 2021/2022 | 9780323641937| CHAPTER 1-21 QUESTIONS AND COMPLETE WELL EXPLAINED 100% CORRECT ANSWERS WITH RATIONALES ALREADY PAS
TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSING 8TH EDITION BY MARY LOU SOLE; DEBORAH GOLDENBERG KLEIN; MARTHE J. MOSELEY | 2021/2022 | 9780323641937| CHAPTER 1-21 QUESTIONS AND COMPLETE WELL EXPLAINED 100% CORRECT ANSWERS WITH RATIONALES ALREADY PASSED VERIFIED BY EXPERTS AND GRADED A+ LATE...
TEST BANK FOR INTRODUCTION TO
CRITICAL CARE NURSING 8TH EDITION
BY MARY LOU SOLE; DEBORAH
GOLDENBERG KLEIN; MARTHE J.
MOSELEY | 2021/2022 |
9780323641937| CHAPTER 1-21
QUESTIONS AND COMPLETE WELL
EXPLAINED 100% CORRECT ANSWERS
WITH RATIONALES ALREADY PASSED
VERIFIED BY EXPERTS AND GRADED A+
LATEST 2024 VERSION WITH 100%
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED TO PASS
YOUR EXAMS)
,
, ANS: D
A hemodynamic value not supported by clinical assessment should be treated as questionable. To
ensure the accuracy of hemodynamic readings, the catheter transducer system must be leveled at the
phlebostatic axis and zero referenced. In this example, the catheter transducer system may be lower
than the phlebostatic axis, resulting in erroneously higher pressures. Clinical manifestations do not
support increasing supplemental oxygen. Clinical manifestations do not warrant physician intervention;
aberrant values should be investigated further. An aberrant value warrants further investigation, which
includes zero referencing and checking the level as an initial measure. A chest x -ray study is not
warranted at this time. While caring for a patient with a pulmonary artery catheter, the nurse notes the
pulmonary artery occlusion pressure (PAOP) to be significantly higher than previously recorded values.
The nurse assesses respirations to be unlabored at 16 breaths/min, oxygen saturation of 98% on 3 L of
oxygen via nasal cannula, and lungs clear to auscultation bilaterally. What is the priority nursing action?
a.
Increase supplemental oxygen and notify respiratory therapy.
b.
Notify the physician immediately of the assessment findings.
c.
Obtain a stat chest x-ray film to verify proper catheter placement.
d.
Zero reference and level the catheter at the phlebostatic axis.
ANS: A
Both hemodynamic parameters and the reported hematocrit value indicate hypovolemia and blood loss
requiring volume resuscitation with blood products. Furosemide administration will worsen fluid volume
status. Inotropic agents will not correct the underlying fluid volume deficit and anemia. Vasoconstrictors
are contraindicated in a volume-depleted state. A patient is admitted to the hospital with multiple
trauma and extensive blood loss. The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135
beats/min, respirations 36 breaths/min, cardiac output (CO) of 2 L/min, systemic vascular resistance of
3000 dynes/sec/cm-5, and a hematocrit of 20%. The nurse anticipates administration of which the
following therapies or medications?
a.
Blood transfusion
b.
Furosemide (Lasix)
c.
Dobutamine (Dobutrex) infusion
, d.
Dopamine hydrochloride (Dopamine) infusion
ANS: A
A cardiac index of 1.2 L/min/m3 combined with the identified clinical assessment findings indicate a low
cardiac output with fluid overload (bilateral crackles) requiring intervention. The remaining
hemodynamic values are within normal limits: cardiac output of 4 L/min; pulmonary vascular resistance
of 80 dynes/sec/cm-5; and the systemic vascular resistance of 1800 dynes/sec/cm-5. The nurse is
caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a
blood pressure of 90/60 mm Hg, heart rate 110 beats/min, respirations 36/min, oxygen saturation of
89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which
hemodynamic value requires immediate action by the nurse?
a.
Cardiac index (CI) of 1.2 L/min/m3
b.
Cardiac output (CO) of 4 L/min
c.
Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm-5
d.
Systemic vascular resistance (SVR) of 1800 dynes/sec/cm-5
ANS: B
Low pulmonary artery occlusion pressures usually indicate volume depletion, so intravenous fluids
would be indicated. Administration of diuretics would worsen the patient's volume status. Negative
inotropes would not improve the patient's volume status. Vasopressors will increase blood pressure but
are contraindicated in a low volume state. While caring for a patient with a small bowel
obstruction, the nurse assesses a pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly
urine output of 5 mL. The nurse anticipates which therapeutic intervention?
a.
Diuretics
b.
Intravenous fluids
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