A student is caring for a patient who suffered massive blood loss after trauma. How does the student correlate the blood loss with the patient's mean arterial pressure (MAP)?

It causes vasoconstriction and increased MAP.

Lower blood volume lowers MAP.

It raises cardiac output and MAP.

There is no direct correlation to MAP.

Answer and Explanation

The Correct Answer is B

Mean arterial pressure (MAP) is a measure of the average pressure within the arteries during one cardiac cycle. It represents the perfusion pressure that drives blood flow to organs and tissues. MAP is calculated using the formula:
MAP = Diastolic blood pressure + 1/3 (Systolic blood pressure - Diastolic blood pressure)
Blood loss, particularly in cases of significant hemorrhage, leads to a decrease in blood volume. When blood volume decreases, there is less circulating blood available to generate pressure within the arterial system. This reduction in blood volume results in decreased MAP.
Therefore, in the case of massive blood loss after trauma, the student can correlate it with a lower blood volume, which in turn leads to a lower MAP. The decrease in blood volume reduces the perfusion pressure, compromising organ and tissue perfusion
A. It causes vasoconstriction and increased MAP in (option A) is incorrect because: While vasoconstriction can occur as a compensatory mechanism to maintain blood pressure, it does not necessarily lead to an increased MAP in the context of significant blood loss.
C. It raises cardiac output and MAP in (option C) is incorrect because Blood loss typically leads to a reduction in cardiac output due to decreased blood volume. Therefore, it does not raise cardiac output and MAP.
D. There is no direct correlation to MAP in (option D) is incorrect because: There is indeed a direct correlation between blood loss and MAP. As blood volume decreases, MAP decreases as well.
Therefore, the correct correlation between blood loss and MAP is that lower blood volume lowers MAP.

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Correct Answer is C

Explanation

The nurse should listen over both lung fields to ensure that air entry is present bilaterally, indicating that the tube is correctly positioned in the trachea. This comes after observing chest movements.

B. Using an end-tidal CO2 monitor to check for placement in the trachea in (option B) is incorrect because End-tidal CO2 monitoring can provide confirmation of correct tube placement in the trachea by detecting exhaled CO2 levels. However, it requires additional equipment and setup, which may not be readily available at the bedside or immediately accessible.
C. Observing the chest for symmetrical movement with ventilation is the initial action after placing an endotracheal tube.
D. Obtaining a portable chest radiograph to check tube placement (option D) is incorrect because Chest radiographs are commonly used to confirm endotracheal tube placement, especially for long-term confirmation or if there are concerns about placement. However, obtaining a portable chest radiograph may involve delays and is not the initial action to be taken for immediate verification.
Therefore, the best initial action by the nurse to verify the correct placement of an endotracheal tube (ET) after insertion is to auscultate for the presence of bilateral breath sounds.

A. Elevated heart rate. B. Elevated respiratory rate. C. Decreased pulse rate. D. Decrease systolic blood pressure. E. Decreased urine output. F. Bilateral crackles in the lung bases.

Correct Answer is ["A","B","D","E"]

Explanation

These manifestations occur as compensatory mechanisms in response to decreased blood volume and compromised tissue perfusion. The body attempts to compensate for the inadequate circulating volume by increasing heart rate (A) and respiratory rate (B) to enhance oxygen delivery.
D. The decreased systolic blood pressure (D) is a result of decreased cardiac output and vasoconstriction in an attempt to maintain perfusion to vital organs.
E. The decreased urine output (E) is a result of decreased renal perfusion due to decreased blood volume.
C. Decreased pulse rate in (option C) is incorrect because it is not typically seen in the compensatory stage of hypovolemic shock. The body tries to increase heart rate to maintain cardiac output and compensate for the decreased blood volume.
F. Bilateral crackles in (option F) is incorrect because the lung bases are more commonly associated with conditions such as pulmonary edema or fluid overload, rather than the compensatory stage of hypovolemic shock.
It's important to note that the manifestations of shock can vary depending on individual patient factors and the underlying cause of shock. Therefore, a comprehensive assessment and clinical judgment are necessary to fully evaluate the patient's condition.

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A student is caring for a patient who suffered massive blood loss after trauma. How does the student correlate the blood loss with the patient's mean arterial pressure (MAP)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To verify the correct placement of an endotracheal tube (ET) after insertion, the best initial action by the nurse is to:

Correct Answer is C

Explanation

The emergency department nurse is assessing a patient who is in the compensatory stage of hypovolemic shock. Which manifestations does the nurse expect? Select all that apply.

Correct Answer is ["A","B","D","E"]

Explanation

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