A nurse is assessing a client's pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?
Hypovolemia
Hypotension
Left ventricular failure
Cardiogenic shock
The Correct Answer is C
Rationale:
A. Hypovolemia: Hypovolemia causes a decrease in PAWP due to reduced circulating blood volume and inadequate venous return to the heart. A low PAWP reflects decreased left ventricular preload, not an elevated value.
B. Hypotension: Hypotension alone does not directly increase PAWP. In fact, low blood pressure often accompanies decreased cardiac filling pressures. Elevated PAWP typically occurs with fluid overload or impaired ventricular function rather than simple hypotension.
C. Left ventricular failure: An elevated PAWP indicates increased left-sided heart pressures due to ineffective left ventricular pumping. Blood backs up into the pulmonary circulation, leading to pulmonary congestion and edema.
D. Cardiogenic shock: In cardiogenic shock, PAWP can be elevated due to impaired contractility, but it is accompanied by low cardiac output and hypotension. While related, the elevated PAWP in cardiogenic shock results from the underlying left ventricular failure, which is the primary cause of the pressure increase.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Rationale:
A. "Perform Kegel exercises several times daily.": Kegel exercises strengthen pelvic floor muscles, improving bladder control and reducing stress incontinence episodes. Regular practice is essential for effectiveness.
B. "Take prescribed diuretics no later than 2000.": Limiting evening diuretic use helps reduce nighttime incontinence but does not address stress incontinence, which is triggered by increased intra-abdominal pressure, not fluid timing.
C. "Maintain a daily fluid intake of 1,000 to 1,200 mL/day.": Restricting fluids excessively can lead to concentrated urine and urinary tract irritation. Adequate hydration is important; fluid restriction is not recommended for stress incontinence.
D. "Attempt to void every 2 hours.": Scheduled voiding helps prevent bladder overfilling, reducing leakage episodes and improving bladder control. This is an effective behavioral strategy.
E. "Maintain optimal body weight for height.": Excess weight increases intra-abdominal pressure, which can worsen stress incontinence. Maintaining a healthy weight helps reduce strain on pelvic floor muscles.
Correct Answer is C
Explanation
Rationale:
A. Zolpidem: Zolpidem is a sedative-hypnotic used for insomnia and does not have known interactions with saw palmetto. It primarily affects the central nervous system and does not influence platelet activity or coagulation pathways.
B. Ipratropium: Ipratropium is an anticholinergic bronchodilator used for respiratory conditions such as COPD and asthma. It does not interact with saw palmetto, as the herb mainly affects hormonal and coagulation pathways rather than respiratory medications.
C. Clopidogrel: Saw palmetto can potentiate the effects of antiplatelet and anticoagulant medications like clopidogrel, increasing the risk of bleeding. The herb exhibits mild antiplatelet activity, which can lead to additive effects and potential hemorrhagic complications when combined with platelet inhibitors.
D. Penicillin: Penicillin is an antibiotic with no pharmacologic interaction with saw palmetto. The herb does not interfere with antibacterial mechanisms or alter antibiotic metabolism, making concurrent use safe from an interaction standpoint.
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