The nurse is providing care to a client who has survived cardiac arrest Which of the following manifestations should alert the nurse to the development of PCAS?
Decreased circulation to the kidneys
Increased mental capacity
Improving respiratory function
Improvement in heart rate and blood pressure
The Correct Answer is A
A. Decreased circulation to the kidneys: Post-cardiac arrest syndrome (PCAS) is a constellation of systemic ischemia/reperfusion injury responses that occur after return of spontaneous circulation (ROSC) following cardiac arrest. One of the manifestations of PCAS is decreased circulation to the kidneys due to the systemic hypoperfusion that occurs during cardiac arrest and the subsequent reperfusion injury that follows ROSC. This can lead to acute kidney injury (AKI) in some cases.
B. Increased mental capacity: While it is crucial to monitor neurological status after cardiac arrest, an immediate increase in mental capacity is not typically indicative of PCAS. Rather, neurological assessment may involve evaluating for signs of brain injury or dysfunction, which can include altered mental status, confusion, or neurological deficits.
C. Improving respiratory function: Improvement in respiratory function after cardiac arrest is a positive sign but may not necessarily indicate the development of PCAS. PCAS primarily involves systemic responses to the ischemia/reperfusion injury that occurs during and after cardiac arrest, rather than isolated respiratory changes.
D. Improvement in heart rate and blood pressure: Improvement in heart rate and blood pressure after cardiac arrest is generally expected with successful resuscitation efforts. However, these improvements alone may not necessarily indicate the development of PCAS. PCAS involves a broader range of systemic responses beyond just cardiac and hemodynamic changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Persistent headache and aggression: While persistent headache and aggression can occur following a traumatic brain injury (TBI), these symptoms are not specific to mild TBI. Aggression is more commonly associated with severe TBI, and persistent headache can occur across the spectrum of TBI severity.
B. Headache and confusion: Headache and confusion are common manifestations of mild TBI. Following a mild TBI, individuals often experience headache, which may be mild to moderate in intensity. Confusion, disorientation, and difficulty concentrating are also typical symptoms of mild TBI due to the transient disruption of cognitive function.
C. Loss of vision and depression: Loss of vision and depression are less commonly associated with mild TBI. These manifestations may occur in more severe cases of TBI or with specific types of brain injury affecting visual pathways. However, they are not typically indicative of mild TBI.
D. Seizures and extremity weakness: Seizures and extremity weakness are more indicative of moderate to severe TBI rather than mild TBI. While mild TBI may result in brief loss of consciousness, seizures and significant extremity weakness are less characteristic of mild TBI and are more commonly observed with more severe brain injuries.
Correct Answer is D
Explanation
A. Creatine kinase (CK) test: While creatine kinase isoenzymes, including CK-MB, can be elevated following myocardial infarction (MI), they are not specific to cardiac muscle injury. CK is found in various tissues throughout the body, so elevated levels can also indicate damage to skeletal muscle or brain tissue, among other sources.
B. Creatine kinase-myocardial band (CK-MB) test: CK-MB is a cardiac-specific isoform of creatine kinase, and elevated levels can indicate myocardial injury, particularly in the context of an acute MI. However, troponin T is a more sensitive and specific marker for myocardial injury.
C. Brain natriuretic peptide (BNP) test: Brain natriuretic peptide is primarily used in the diagnosis and management of heart failure. While elevated BNP levels can indicate heart muscle strain or stress, they are not specific markers for acute myocardial infarction or early injury to the cardiac muscle.
D. Troponin T test: This is the correct answer. Troponin T is a highly specific marker for cardiac muscle injury. Elevated troponin levels can be detected within hours of myocardial infarction and persist for several days, making it an essential tool in the diagnosis of acute coronary syndromes, including myocardial infarction. Troponin T is considered one of the gold standard biomarkers for detecting early injury to the cardiac muscle.
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