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?

Cardiogenic shock

Left ventricular failure

Hypotension

Hypovolemia

Answer and Explanation

The Correct Answer is B

Choice A reason: Cardiogenic shock involves reduced cardiac output, typically with low PAWP due to decreased preload from poor heart function. Elevated PAWP reflects left atrial pressure buildup, not characteristic of cardiogenic shock alone, which is distinct from heart failure, requiring specific hemodynamic management.
Choice B reason: Elevated PAWP indicates left ventricular failure, where the heart cannot pump blood effectively, causing pulmonary congestion. This increases left atrial pressure, leading to pulmonary edema, a hallmark of heart failure. Diuretics and inotropes are needed to reduce fluid overload and improve cardiac function.
Choice C reason: Hypotension is a symptom, not a direct complication of elevated PAWP. It may occur in heart failure due to reduced cardiac output, but elevated PAWP specifically signals left heart dysfunction, not hypotension itself, which is a systemic response rather than a primary cardiac issue.
Choice D reason: Hypovolemia reduces blood volume, lowering PAWP due to decreased preload. Elevated PAWP suggests fluid overload or left ventricular dysfunction, not hypovolemia, which presents with low central venous pressure and dehydration signs, requiring fluid resuscitation rather than management of heart failure.

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Correct Answer is C

Explanation

A. Maternal fever Maternal fever typically causes fetal tachycardia (elevated baseline >160/min), not bradycardia. Fever increases maternal metabolic rate and fetal heart rate.
B. Chorioamnionitis This intrauterine infection also leads to fetal tachycardia, due to inflammatory stress and maternal fever. It is not a cause of bradycardia.
C. Maternal hypoglycemia ✅ Low maternal glucose levels can reduce fetal energy supply and oxygenation, leading to fetal bradycardia (baseline <110/min). This is a recognized cause of sustained bradycardia.
D. Fetal anemia Fetal anemia usually results in tachycardia as the fetus compensates for reduced oxygen‑carrying capacity by increasing heart rate. It does not cause bradycardia.

A. Limit your child's potassium intake while she is taking this medication. B. Repeat the dose if your child vomits within 1 hour after taking the medication. C. You can add the medication to a half-cup of your child's favorite juice. D. Have your child drink a small glass of water after swallowing the medication.

Correct Answer is D

Explanation

Choice A reason: Limiting potassium intake is dangerous with digoxin, as low potassium (hypokalemia) increases the risk of digoxin toxicity by enhancing drug binding to cardiac cells. Adequate potassium levels are critical for safe use, as digoxin affects cardiac contractility, making this instruction incorrect and potentially harmful.
Choice B reason: Repeating a digoxin dose if the child vomits within 1 hour is unsafe without medical consultation, as it risks overdose. Digoxin has a narrow therapeutic index, and toxicity can cause arrhythmias. Parents should contact the provider for guidance, making this instruction incorrect and dangerous.
Choice C reason: Adding digoxin to juice risks inaccurate dosing, as the child may not consume the full amount, leading to underdosing or toxicity if additional doses are given. Precise administration (e.g., via syringe) ensures correct dosing, critical for digoxin’s narrow therapeutic range, making this instruction inappropriate.
Choice D reason: Having the child drink water after digoxin ensures the dose is fully swallowed, preventing loss from spitting or incomplete ingestion. This supports accurate dosing, essential for digoxin’s safe use in heart failure, where it enhances cardiac output. This instruction is safe and effective, making it correct.

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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?

Nursing Test Bank

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