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 A
Explanation
The increased respiratory rate and pulse rate can be indicators of physiological changes or potential complications in the patient's condition. These changes may suggest alterations in tissue perfusion or other underlying issues that require further assessment.
Assessing the patient's tissue perfusion includes evaluating additional vital signs, such as blood pressure, oxygen saturation, and capillary refill time. Assessing skin color, temperature, and moisture, as well as peripheral pulses, can also provide important information regarding tissue perfusion.
B. Pain medication (option B) is incorrect because the increased respiratory and pulse rates could also indicate other factors that require assessment before administering pain medication.
C. Documenting the findings in the patient's chart (option C) is incorrect because it should not be the primary action at this point. Assessing the patient's condition and determining appropriate interventions take priority.
D. Increasing the rate of the patient's IV infusion (option D) is incorrect because may not be the most appropriate action without further assessment. The patient's increased respiratory and pulse rates may not necessarily be related to hydration status, and it is important to assess the patient comprehensively before making changes to the IV infusion rate.
Therefore, the best action by the nurse in this situation is to further assess the patient's tissue perfusion to gather more information and determine the appropriate course of action.
Correct Answer is D
Explanation
When the low-pressure alarm sounds, it indicates that the pressure being detected by the arterial line is below the set threshold. This could be due to a variety of reasons, such as a loose connection, air bubbles, or a shift in the zero-reference point.
Rezeroing the monitoring equipment involves recalibrating or resetting the baseline reference point for the arterial pressure waveform. This ensures accurate measurement and monitoring of the patient's arterial pressure.
A. Checking the right hand for a rash in (option A) is incorrect because While assessing the patient for any skin changes or rashes is important, it is not the first action to take in response to a low-pressure alarm.
B. Assessing the waveform for under-dampening in (option B) is incorrect because Assessing the waveform characteristics is important in arterial line monitoring, but it may not be the initial action when the low-pressure alarm sounds. Rezeroing the equipment should be performed before assessing waveform characteristics.
C. Assessing for cardiac dysrhythmias in (option C) is incorrect because Assessing for dysrhythmias is an important aspect of patient care, but it may not be directly related to the low-pressure alarm from the arterial line. Rezeroing the monitoring equipment takes precedence.
Therefore, when the low-pressure alarm sounds for a patient with an arterial line, the nurse should first re-zero the monitoring equipment to ensure accurate measurement of arterial pressure.
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