In the plan of care, the most important intervention for a patient experiencing shock is assessing:
Respirations rate.
Heart rate.
Blood pressure.
Temperature.
The Correct Answer is C
A) Respirations rate:
Respiratory rate is an important vital sign to monitor in patients with shock, as respiratory distress can indicate inadequate oxygenation. However, blood pressure is generally considered more critical to assess initially in the context of shock because it directly reflects tissue perfusion and oxygen delivery.
B) Heart rate:
Heart rate is an important vital sign to monitor in patients with shock, as tachycardia (rapid heart rate) may indicate the body's compensatory response to maintain cardiac output and tissue perfusion. However, blood pressure is generally considered more critical to assess initially in the context of shock because it directly reflects tissue perfusion and oxygen delivery.
C) Blood pressure.
In shock, the body's vital organs are not receiving adequate blood flow and oxygen, leading to a life-threatening condition. While all vital signs are important to monitor in a patient experiencing shock, blood pressure is typically considered the most critical because it reflects the perfusion pressure—the force driving blood through the circulatory system to deliver oxygen and nutrients to the body's tissues. A decrease in blood pressure can indicate inadequate tissue perfusion and impending organ failure. Therefore, timely assessment and monitoring of blood pressure are essential for identifying and managing shock effectively.
D) Temperature:
Temperature monitoring is important in assessing for signs of infection or other systemic issues that may contribute to shock, such as sepsis. However, blood pressure is generally considered more critical to assess initially in the context of shock because it directly reflects tissue perfusion and oxygen delivery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Inspiration:
Inspiration refers to the process of inhaling or breathing in air into the lungs. It involves the contraction of the diaphragm and expansion of the chest cavity, leading to the intake of air into the lungs.
B) Expiration:
Expiration, also known as exhalation, refers to the process of exhaling or breathing out air from the lungs. It involves the relaxation of the diaphragm and chest muscles, leading to the expulsion of air from the lungs.
C) Respiration:
Respiration is a broader term that encompasses both ventilation (the mechanical process of breathing) and gas exchange (the exchange of oxygen and carbon dioxide between the lungs and blood). While respiration involves both air movement and gas exchange, it does not specifically refer to blood flow through the lung, which is described by the term perfusion.
D) Perfusion.
Perfusion refers to the circulation of blood through the lung's blood vessels, including the pulmonary arteries and pulmonary capillaries. This process allows for the exchange of gases (oxygen and carbon dioxide) between the blood and the air in the lungs during respiration. Perfusion is essential for oxygenating blood and removing carbon dioxide, which is crucial for maintaining normal cellular function throughout the body.
Correct Answer is C
Explanation
A. Decreased cardiac output: Inotropic medications are intended to improve cardiac function and increase cardiac output, so monitoring for signs of decreased cardiac output would be contrary to the expected therapeutic effect of these medications.
B. Increased afterload: Inotropic medications primarily affect the contractility of the heart muscle and do not typically have a direct effect on afterload (the force against which the heart must pump blood). While changes in afterload can occur as a secondary consequence of altered cardiac function, monitoring for signs of increased afterload would not be the primary focus after administering an inotropic medication.
C. Increased cardiac output.
Inotropic medications are drugs that affect the contractility of the heart muscle. They are often used in the management of shock to improve cardiac function and increase cardiac output. Therefore, after administering an inotropic medication, the nurse would monitor the patient for signs of increased cardiac output, such as improved peripheral perfusion, increased blood pressure, and resolution of signs and symptoms of shock.
D. Slowing of the heart rate: Inotropic medications can affect heart rate indirectly by altering cardiac output, but their primary effect is on contractility rather than heart rate. Monitoring for signs of bradycardia (slowing of the heart rate) may be appropriate in certain clinical situations, but it is not the primary consideration after administering an inotropic medication for shock.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.