An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. What should the nurse plan to do?

Give PRN lorazepam (Ativan) and cancel the transfer.

Obtain an order for restraints as needed and transfer the patient.

Notify the health care provider and postpone the transfer.

Inform the receiving nurse and then transfer the patient.

Answer and Explanation

The Correct Answer is C

C. This allows for the patient's condition to be re-evaluated, ensuring that they receive the necessary care and attention before being transferred.

A. Benzodiazepines can cause sedation, cognitive impairment, and delirium, which may worsen the patient's condition. Canceling the transfer without addressing the underlying cause of confusion may delay appropriate management.

B. Restraints can increase agitation, anxiety, and risk of injury, and they do not address the underlying cause of confusion. Restraints should only be considered as a last resort if all other measures to ensure patient safety have been exhausted.

D. This option is not appropriate because transferring the patient without addressing the new-onset confusion could compromise patient safety. It's essential to identify and manage the underlying cause of confusion before transferring the patient to another unit.

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Correct Answer is B

Explanation

B. Sodium nitroprusside is a potent vasodilator used to reduce systemic vascular resistance and afterload, thereby improving cardiac output and tissue perfusion in cardiogenic shock. In this scenario, where the patient has cool and clammy skin with high SVR, indicating peripheral vasoconstriction,

increasing the rate of sodium nitroprusside infusion can help vasodilate peripheral vessels, reduce afterload, and improve tissue perfusion

A. Dopamine is a medication commonly used in the management of cardiogenic shock to increase cardiac output and systemic blood pressure. However, in this scenario where the patient is cool and clammy with high SVR, indicating vasoconstriction and potential peripheral hypoperfusion, increasing the rate of dopamine infusion may further increase systemic vascular resistance and exacerbate peripheral vasoconstriction. This can worsen tissue perfusion and exacerbate the patient's condition.

C. Nitroglycerin is another vasodilator commonly used in the management of cardiogenic shock to reduce preload and afterload, thereby improving cardiac output and tissue perfusion. However, decreasing the rate of nitroglycerin infusion may further exacerbate vasoconstriction and increase SVR, worsening tissue perfusion in this scenario. Therefore, decreasing the rate of nitroglycerin infusion is not indicated.

D. Intravenous fluids such as 5% dextrose in normal saline are typically administered to maintain adequate intravascular volume and perfusion pressure in shock states. However, decreasing the rate of intravenous fluid infusion may further decrease intravascular volume and preload, potentially exacerbating hypoperfusion and worsening the patient's condition. Therefore, decreasing the rate of intravenous fluid infusion is not indicated in this scenario.

A. Respiratory rate B. Stroke volume C. Heart rate D. Blood pressure

Correct Answer is ["B","C"]

Explanation

B. stroke volume is the amount of blood ejected from the left ventricle with each contraction (systole) of the heart. Changes in stroke volume directly affect cardiac output. An increase in stroke volume leads to an increase in cardiac output, while a decrease in stroke volume results in a decrease in cardiac output. Factors that can affect stroke volume include preload, afterload, and contractility of the heart.

C. Heart rate refers to the number of heartbeats per minute. Heart rate directly affects cardiac output by determining how frequently the heart contracts and pumps blood. An increase in heart rate (tachycardia) leads to an increase in cardiac output, while a decrease in heart rate (bradycardia) results in a decrease in cardiac output. Factors such as sympathetic and parasympathetic nervous system activity, hormones, and medications can influence heart rate.

A. Respiratory rate does not directly affect stroke volume or heart rate but changes in respiratory rate can indirectly impact cardiac output through their effects on venous return and preload.

D. Blood pressure represents the force exerted by the blood against the walls of the arteries. While blood pressure does not directly affect cardiac output, it is influenced by cardiac output and systemic vascular resistance (SVR).

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An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. What should the nurse plan to do?

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Naxlex Comprehensive Predictor Exams

An older patient with cardiogenic shock is cool and clammy. Hemodynamic monitoring indicates a high systemic vascular resistance (SVR). Which intervention should the nurse anticipate?

Correct Answer is B

Explanation

Which of the following factors can directly affect cardiac output?

Correct Answer is ["B","C"]

Explanation

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A patient who has been involved in a motor vehicle crash arrives in the emergency department (ED) with cool, clammy skin; tachycardia; and hypotension. Which intervention prescribed by the health care provider should the nurse implement first?

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Which of the following medications is commonly used for afterload reduction in critical care?

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