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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Dehydration is not directly associated with gastroesophageal reflux, which involves gastric acid backflow. Dehydration affects fluid balance, not reflux mechanisms, so this statement is inaccurate and irrelevant to preterm contractions, making it incorrect.
Choice B reason: Dehydration is not caused by decreased hemoglobin and hematocrit; rather, it may elevate these due to hemoconcentration. This statement reverses the relationship, making it factually incorrect and unrelated to preterm labor risks.
Choice C reason: Dehydration can increase preterm labor risk by reducing uterine blood flow and triggering contractions via oxytocin release. This evidence-based link supports hydration as a preventive measure, making it the correct statement for teaching in this scenario.
Choice D reason: Dehydration is treated with fluid replacement, not calcium supplements, which address bone health or specific deficiencies. This treatment is irrelevant to dehydration or preterm labor, making it an incorrect and inappropriate recommendation.
Correct Answer is D
Explanation
Choice A reason: Providing transportation information is helpful but does not directly coordinate care, as it addresses access rather than securing services. Coordination involves arranging specific care delivery, so this action is supportive but less comprehensive, making it incorrect for demonstrating care coordination.
Choice B reason: Encouraging self-advocacy empowers the client but does not actively coordinate care, which requires arranging services or resources. This action is educational, not logistical, and does not ensure access to health services, making it incorrect for this context.
Choice C reason: Informing about providers who accept insurance is informative but not sufficient for coordination, which involves facilitating actual care delivery. Without arranging services, this action remains preparatory, making it less effective than directly securing an appointment, thus incorrect.
Choice D reason: Arranging an appointment with a mobile health clinic directly facilitates access to care, addressing rural barriers. This active coordination ensures the client receives services, aligning with case management principles for underserved populations, making it the correct demonstration of care coordination.
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