A client was admitted to the intensive care unit after having an abdominal aortic aneurysm resection. The client's cardiac monitor shows a heart rate of 110. The clients hemodynamic monitoring shows a Central Venous Pressure (CVP): 1 mmHg and a Pulmonary Arterial Wedge Pressure (PAWP): 3 mmHg. Which health care provider order would the nurse anticipate receiving?
Monitor hemodynamic monitoring parameters again in one hour.
Administer Furosemide (Lasix) 20mg IVP.
Decrease IV Fluids to 75ml/hr and recheck hemodynamic parameters.
Administer 0.9% Normal Saline @ 150ml/hr
The Correct Answer is D
A. Although monitoring hemodynamic parameters is important, this option does not address the immediate issue of low preload, as indicated by the low CVP and PAWP, suggesting hypovolemia.
B. Furosemide is a diuretic and would further decrease intravascular volume, which is inappropriate given the signs of hypovolemia.
C. Decreasing IV fluids would exacerbate the low preload and worsen the client's condition by reducing intravascular volume even further.
D. Administering 0.9% Normal Saline @ 150 mL/hr is the most appropriate intervention. The low CVP and PAWP indicate hypovolemia, and increasing fluid administration will help to increase the preload, thereby improving the client's hemodynamic status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Amiodarone is an antiarrhythmic used to treat ventricular arrhythmias like monomorphic VT, but it is not the first-line treatment for a pulseless patient. Defibrillation should be performed immediately, and amiodarone can be administered after defibrillation if the rhythm persists.
B. CPR is essential for maintaining circulation in a pulseless patient, but defibrillation should be the first priority for monomorphic VT. CPR should be continued if defibrillation is not immediately available, but the most effective intervention is defibrillation to attempt to restore normal rhythm.
C. Cardioversion is used for stable, regular arrhythmias, but for a pulseless client in monomorphic VT, defibrillation is the appropriate first intervention. Cardioversion is typically used when the patient is conscious or stable and is not a priority for pulseless VT.
D. For a pulseless client with monomorphic ventricular tachycardia, defibrillation is the priority intervention. Defibrillation delivers an electric shock to the heart, which may terminate the abnormal rhythm and allow the heart to return to normal sinus rhythm. This is the most effective and immediate treatment for a pulseless client in ventricular tachycardia.
Correct Answer is D
Explanation
A. "They will circulate my blood on a machine during the surgery.": This is correct information regarding the use of a heart-lung machine during CABG.
B. "I will need to take an aspirin every day after the surgery to keep the graft open.": Daily aspirin therapy is standard to prevent graft occlusion, indicating correct understanding.
C. "They will use an artery near my heart to go around the area that is blocked.": This accurately describes using the internal mammary artery for the bypass, showing correct knowledge.
D. "I will have small incisions in my leg where they will remove the vein.": This indicates confusion, as the internal mammary artery, not leg veins, is used in this type of CABG.
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