Following surgery, a patient's central venous pressure (CVP) monitor indicates high pressures. Which action will the nurse anticipate taking?
Increase the IV fluid infusion rate.
Administer IV diuretic medications.
Elevate the head of the patient's bed to 45 degrees.
Document the CVP and continue to monitor.
The Correct Answer is B
Central venous pressure (CVP) is a measurement of the pressure in the central veins, which reflects the blood volume and right-sided cardiac function. High CVP readings may indicate fluid overload or impaired cardiac function, and intervention is necessary to address the underlying cause.
Administering IV diuretic medications can help reduce fluid volume by increasing urine output and promoting fluid elimination. By removing excess fluid, the diuretic medications can help lower the CVP and alleviate the high pressures.
The other options mentioned are not the anticipated actions for addressing high CVP:
A. Increasing the IV fluid infusion rate in (option A) is incorrect because: If the CVP is already indicating high pressures, increasing the IV fluid infusion rate would further contribute to fluid overload and exacerbate the problem. This action would not be appropriate for high CVP readings.
C. Elevating the head of the patient's bed to 45 degrees in (option C) is incorrect because Positioning the patient with the head of the bed elevated is commonly done to prevent complications such as aspiration or improve respiratory function. While it may have other benefits, it does not directly address the high CVP.
D. Documenting the CVP and continuing to monitor in (option D) is incorrect because Documenting the CVP and continuing to monitor is important for ongoing assessment and evaluation. However, in the presence of high CVP readings, intervention is necessary to address the underlying issue rather than solely documenting and monitoring.
Therefore, when a patient's CVP monitor indicates high pressures following surgery, the nurse would anticipate administering IV diuretic medications to help reduce fluid volume and lower the CVP.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["9"]
Explanation
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Doseinmcg/min=2mcg/kg/min×60kg=120mcg/min
Convert this to mg/min since the concentration is in mg:
120mcg/min=0.12mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120mcg/min=0.12mg/min
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Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200mg250mL=0.8mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250mL200mg=0.8mg/mL
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Calculate the pump rate in mL/min:
To find the rate in mL/min needed to deliver 0.12 mg/min:
Pumprate=Desireddose(mg/min)Concentration(mg/mL)\text{Pump rate} = \frac{\text{Desired dose (mg/min)}}{\text{Concentration (mg/mL)}}Pumprate=Concentration(mg/mL)Desireddose(mg/min)
Pumprate=0.12mg/min0.8mg/mL=0.15mL/min\text{Pump rate} = \frac{0.12 \text{ mg/min}}{0.8 \text{ mg/mL}} = 0.15 \text{ mL/min}Pumprate=0.8mg/mL0.12mg/min=0.15mL/min
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Convert the pump rate to mL/hour:
Multiply by 60 to convert from mL/min to mL/hour:
Pumprate=0.15mL/min×60min/hour=9mL/hour\text{Pump rate} = 0.15 \text{ mL/min} \times 60 \text{ min/hour} = 9 \text{ mL/hour}Pumprate=0.15mL/min×60min/hour=9mL/hour
So, you should set the pump to deliver Dopamine at a rate of 9 mL/hour.
Correct Answer is C
Explanation
Septic shock is characterized by inadequate tissue perfusion and hypotension, which can lead to organ dysfunction and failure. The administration of intravenous fluids, such as a normal saline bolus, is the initial priority in the management of septic shock to restore intravascular volume and improve perfusion.
A. Draw an arterial blood gas (ABG) in (option A) is incorrect because: ABG may be ordered to assess the patient's acid-base status and oxygenation, but addressing hypotension and restoring perfusion through fluid administration takes priority.
B. Start insulin drip to maintain blood glucose at 150 mg/dl or lower in (option B) is incorrect because: Hyperglycaemia is commonly observed in critically ill patients, including those with septic shock. While controlling blood glucose is important, it is not the immediate priority compared to addressing hypotension and restoring intravascular volume.
D. Titrate norepinephrine (Levophed) to keep mean arterial pressure (MAP) greater than 65 mm Hg in (option D) is incorrect because: Norepinephrine is a vasopressor medication used to increase blood pressure and perfusion in septic shock. While it may be necessary for the management of septic shock, fluid resuscitation should be initiated first to optimize intravascular volume before starting vasopressors.
Therefore, the first order that the nurse should accomplish in this scenario is to give a normal saline bolus IV of 30 mL/kg to address the hypotension and restore intravascular volume.
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