Quiz 2
Notify the physician and obtain a temporary pacemaker.
A patient becomes unresponsive. The patient's heart rate is 32 beats/min in an idioventricular rhythm; blood pressure is 60/32 mm Hg; SpO2 is 90%; and respiratory rate is 14 breaths/min. Which intervention would the nurse do first?
The patient is experiencing heart failure and has too much preload.
A patient is admitted with right- and left-sided heart failure. The nurse's assessment reveals that the patient has 3+ pitting edema on the sacrum, blood pressure of 176/98 mm Hg, and bilateral crackles in the lungs. The patient is experiencing shortness of breath and chest discomfort. On the basis of this information, how would the nurse evaluate the patient's preload status?
Drawing a serum magnesium level
A patient with a potassium level of 2.8 mEq/L is given 60 mEq over a 12-hour period. A repeat potassium level is obtained, and the current potassium level is 3.2 mEq/L. In addition to administering additional potassium supplements, what intervention should now be considered?
Tall, peaked T waves
A patient with a serum potassium level of 6.8 mEq/L may exhibit what type of electrocardiographic changes?
Check the level of the transducer.
A patient's central venous pressure (CVP) reading suddenly increased from 10 to 48 mm Hg. His lungs are clear except for fine rales at the bases. What should the nurse do next?
Transcutaneous
Noninvasive emergency pacing is best achieved via the use of which type of temporary pacing?
"You cannot get up because you may start bleeding."
On returning from the cardiac catheterization laboratory, the patient asks if he can get up in the chair. What should the nurse tell the patient?
Pink, frothy sputum
The nurse is caring for a patient with left-sided heart failure. The nurse suspects the patient is developing pulmonary edema. Which finding would confirm the nurse's suspicions?
- Dobutamine - Intraaortic balloon pump - Nesiritide
The patient diagnosed with chronic heart failure for the past 10 years has been treated with beta-blockers and angiotensin-converting enzyme inhibitors as well as diuretics. The symptoms have recently worsened, and now the patient presents to the ED with severe shortness of breath and crackles throughout lung fields. Respirations are labored and arterial blood gases show that there is at risk for respiratory failure. Which of the following therapies may be used for acute, short-term management of the patient? (Select all that apply.)
Elevated central venous pressure and sacral edema
What are the clinical manifestations of right-sided heart failure?
As preload increases, cardiac output increases until it overstretches the ventricle and cardiac output decreases.
What is the effect of preload on cardiac output?
Adding the systolic pressure and two diastolic pressures and then dividing by 3
What is the formula for calculating mean arterial pressure (MAP)?
Prevent backflow of blood into the atria during ventricular contraction
What is the function of the atrioventricular (AV) valves?
Identify the cause
What is the initial intervention in a patient with sinus tachycardia with the following vital signs: heart rate, 136 beats/min; blood pressure, 102/60 mm Hg; respiratory rate, 24 breaths/min; temperature, 99.2° F; SpO2, 94% on oxygen 2 L/min by nasal cannula?
Decreased left atrial tension
What is the physiologic effect of left ventricular afterload reduction?
Pulselessness
What major clinical finding is present with ventricular fibrillation (VF)?
Diuretic use
What places a patient with heart failure at risk for hypomagnesemia?
B-type natriuretic peptide (BNP)
Which cardiac biomarker is elevated in decompensated heart failure?
- cool, pale extremities - weak peripheral pulses
Which clinical manifestations are indicative of left ventricular failure? (Select all that apply, one, some, or all.)
Tearing in the chest, abdomen, or back
Which description best describes the pain associated with aortic dissection?
- Rapid resolution of ST elevation - Rapid rise in creatine kinase MB fraction
Which signs and symptoms would indicate successful reperfusion after administration of a fibrinolytic agent? (Select all that apply)
The Allen test assesses the adequacy of blood flow through the ulnar artery.
Which statement best describes the purpose of the Allen test?
It increases the patient's risk for a stroke
Why is a new onset of atrial fibrillation serious?
It can detect an imbalance between oxygen supply and metabolic tissue demand.
Why is mixed venous oxygen saturation (SVO2) monitoring helpful in the management of the critically ill patient?
An increasing QT interval increases the risk of torsades de pointes.
Why is the measurement of the QT interval important?
