Which action should the nurse take first when the low pressure alarm sounds for a patient who has an arterial line in the left radial artery?

Re-zero the monitoring equipment.

Check the left hand for pallor.

Fast flush the arterial line.

Assess for dysrhythmias

Answer and Explanation

The Correct Answer is B

B. Checking the left hand for pallor can help assess peripheral perfusion and determine if there is adequate blood flow distal to the arterial line insertion site. Pallor in the left hand could indicate decreased perfusion, which may contribute to the low-pressure alarm.

A. Re-zeroing the monitoring equipment may be necessary to ensure accurate pressure readings. However, it should not be the first action taken when the low-pressure alarm sounds. Before re-zeroing, the nurse should assess the patient's condition to ensure there are no immediate issues affecting arterial pressure.

C. Fast flushing the arterial line is not typically the first action to take when the low-pressure alarm sounds. Fast flushing may increase the risk of dislodging the catheter or causing air embolism if there is a problem with the line.

D. Assessing for dysrhythmias should be part of the overall assessment but may not be the first action taken in response to the alarm.

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Correct Answer is A

Explanation

A. In a patient receiving a dobutamine infusion, which is a vasopressor medication used to increase cardiac output, a cool and pale IV infusion site could indicate inadequate perfusion despite treatment. This finding requires immediate action to assess the patient's hemodynamic status and ensure adequate tissue perfusion.

B. Warm and dry extremities are typically indicative of adequate tissue perfusion. In neurogenic shock, vasodilation can lead to warm extremities due to decreased systemic vascular resistance. While this finding may be expected in neurogenic shock, it does not necessarily indicate a need for immediate action if other parameters are stable.

C. Decreased urine output can be indicative of inadequate renal perfusion and impaired kidney function. In a patient with neurogenic shock, maintaining adequate renal perfusion is crucial to prevent acute kidney injury. While decreased urine output warrants close monitoring and intervention, it may not require immediate action unless other signs of worsening perfusion are present.

D. A heart rate of 58 beats/min may be within the normal range for some patients, especially those who are receiving dobutamine, which can have a chronotropic effect. However, in the context of neurogenic shock, bradycardia may indicate a compensatory response to hypotension and decreased tissue perfusion. While bradycardia alone may not always require immediate action, it should prompt further assessment of the patient's hemodynamic status and response to treatment.

A. The patient's central venous pressure is 3 mm Hg. B. The patient is receiving low dose dopamine. C. The patient is in sinus tachycardia at 120 beats/min. D. The patient has had no urine output since admission.

Correct Answer is A

Explanation

A Adequate fluid administration is essential before giving vasopressors to patients with hypovolemic shock. The patient’s low central venous pressure indicates a need for more volume replacement. The other patient data are not contraindications to norepinephrine administration.

B Low dose dopamine is not a contraindication to epinephrine administration.

C A sinus tachycardia is not a contraindication to epinephrine administration

D Lack of urine output is not a contraindication to epinephrine administration

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Which action should the nurse take first when the low pressure alarm sounds for a patient who has an arterial line in the left radial artery?

Nursing Test Bank

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