The nurse is caring for a patient with a left radial arterial line and a pulmonary artery catheter inserted into the right subclavian vein. Which action by the nurse best ensures the safety of the patient being monitored with invasive hemodynamic monitoring lines?
Document all waveform values.
Limit the pressure tubing length.
Zero reference the system daily.
Ensure alarm limits are turned on
The Correct Answer is D
A. Documentation of waveform values is important but does not directly enhance patient safety during monitoring.
B. Limiting the pressure tubing length can help maintain accuracy, but it is not the primary safety measure.
C. Zero referencing is crucial for accurate readings, but it must be done in conjunction with ensuring alarms are active.
D. Ensuring that alarm limits are turned on and appropriately set is the best safety measure to immediately alert the nurse to any critical changes in the patient's status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Continuous IV infusion is the most appropriate route for treating hypertensive emergencies because it allows for rapid and controlled reduction of blood pressure, which is crucial in preventing target organ damage.
B. Sublingual administration is not recommended in hypertensive emergencies because it does not allow for the precise control needed in these situations.
C. Intramuscular administration is generally not used for antihypertensive agents in emergencies because it does not provide the rapid and adjustable response that IV infusion does.
D. Oral administration is too slow in onset for hypertensive emergencies and is not appropriate when immediate blood pressure control is necessary.
Correct Answer is ["B","C","E"]
Explanation
A. Crackles are more commonly associated with left ventricular failure, which leads to pulmonary congestion.
B. Hepatomegaly, or an enlarged liver, is a sign of right ventricular failure due to blood backing up in the systemic circulation.
C. Jugular venous distention is a classic sign of right ventricular failure as blood accumulates in the venous system.
D. Orthopnea, or difficulty breathing while lying down, is more indicative of left ventricular failure.
E. Peripheral edema is a hallmark of right ventricular failure, resulting from increased venous pressure.
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