To determine the effectiveness of medications that a patient has received to reduce left ventricular afterload, which hemodynamic parameter will the nurse monitor?
Pulmonary artery wedge pressure (PAWP)
Systemic vascular resistance (SVR)
Pulmonary vascular resistance (PVR)
Central venous pressure (CVP)
The Correct Answer is B
Systemic vascular resistance represents the resistance to blood flow in the systemic circulation. It is an important indicator of afterload, which is the force against which the left ventricle must pump to eject blood into the systemic circulation. By monitoring the changes in SVR, the nurse can assess the impact of medications aimed at reducing left ventricular afterload.
A. Pulmonary artery wedge pressure (PAWP) in (option A) is incorrect because: PAWP is a measure of left ventricular preload and reflects the pressure within the left atrium and left ventricle at end-diastole. It is not specifically related to afterload reduction.
C. Pulmonary vascular resistance (PVR) in (option C) is incorrect because: PVR represents the resistance to blood flow in the pulmonary circulation. It is not directly related to left ventricular afterload.
D. Central venous pressure (CVP) in (option D) is incorrect because: CVP reflects the pressure in the right atrium and is an indicator of right-sided cardiac function. It is not specifically related to left ventricular afterload reduction.
Therefore, to assess the effectiveness of medications in reducing left ventricular afterload, the nurse should monitor the systemic vascular resistance (SVR).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Septic shock is a life-threatening condition characterized by severe infection, systemic inflammation, and inadequate tissue perfusion. In this critical situation, one of the initial priorities is to restore intravascular volume and improve tissue perfusion. Initiation of an intravenous line allows for the administration of fluids and other necessary medications to support the patient's hemodynamic stability.
While the other interventions mentioned are also important components of septic shock management, the immediate priority is to address hypotension and tissue hypoperfusion through fluid resuscitation:
A. Obtaining wound and blood cultures in (option A) is incorrect because: Cultures are important to identify the source and causative organisms of the infection. However, fluid resuscitation should take priority over obtaining cultures, as it is necessary to stabilize the patient's hemodynamics.
B. Removing or controlling potentially infected sources in (option B) is incorrect because: Identifying and controlling the source of infection is crucial in septic shock management to prevent further progression. However, initiating fluid resuscitation is more time-sensitive and should be prioritized.
D. Drawing blood for hematology and chemistry studies in (option D) is incorrect because Laboratory studies are important for evaluating organ function and guiding treatment. However, the immediate focus should be on fluid resuscitation to address the underlying hypoperfusion and stabilize the patient's condition.
Therefore, the intervention considered a priority when treating a patient who presents with septic shock is the initiation of an intravenous line and fluid administration to restore intravascular volume and improve tissue perfusion.
Correct Answer is ["A","B","D","E"]
Explanation
These manifestations occur as compensatory mechanisms in response to decreased blood volume and compromised tissue perfusion. The body attempts to compensate for the inadequate circulating volume by increasing heart rate (A) and respiratory rate (B) to enhance oxygen delivery.
D. The decreased systolic blood pressure (D) is a result of decreased cardiac output and vasoconstriction in an attempt to maintain perfusion to vital organs.
E. The decreased urine output (E) is a result of decreased renal perfusion due to decreased blood volume.
C. Decreased pulse rate in (option C) is incorrect because it is not typically seen in the compensatory stage of hypovolemic shock. The body tries to increase heart rate to maintain cardiac output and compensate for the decreased blood volume.
F. Bilateral crackles in (option F) is incorrect because the lung bases are more commonly associated with conditions such as pulmonary edema or fluid overload, rather than the compensatory stage of hypovolemic shock.
It's important to note that the manifestations of shock can vary depending on individual patient factors and the underlying cause of shock. Therefore, a comprehensive assessment and clinical judgment are necessary to fully evaluate the patient's condition.
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