Week 1 - PrepU Hemodynamics Questions
The critical care nurse is caring for a client with a central venous pressure (CVP) monitoring system. The nurse notes that the client's CVP is increasing. This may indicate:
hypervolemia
The nurse cares for a client in the ICU who is being monitored with a central venous pressure (CVP) catheter. The nurse records the client's CVP as 8 mm Hg and recognizes that this finding indicates the client is experiencing which condition?
hypervolemia *higher the CVP, higher the volume!!
What is a negative effect of IV nitroglycerin for shock management that the nurse should assess for in a client?
decreased blood pressure *serious side effect of IV nitro is hypotension (must monitor frequently!
The client asks the nurse what urine output has to do with cardiac function. What is the best response by the nurse?
"poor urine output may indicate inadequate blood flow to the kidneys"
A nurse is discussing cardiac hemodynamics with a client and explains the concept of afterload. What are other preexisting medical conditions to discuss that may increase afterload?
- aging - hypertension - aortic valve stenosis
The nurse is administering colloids to a client during the first 6 hours of septic shock. What is the client's central venous pressure reading goal?
8-12 mmHg (or higher)
The nurse is responsible for monitoring cardiovascular function in a postoperative patient. What method can the nurse use to measure cardiovascular function?
Central Venous Pressure
A nurse is caring for a client in the cardiovascular intensive care unit following a coronary artery bypass graft. Which clinical finding requires immediate intervention by the nurse?
Central venous pressure reading of 1 *tells us the patient is hypovolemic
A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?
Head of the bed elevated 45 degrees AND lower arms supported by pillows (this eliminates fatigue caused by the pull of the client's weight on the shoulder muscles)
A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload?
IV morphine
The central venous pressure (CVP) reading in hypovolemic shock is typically which of the following?
LOW
The nurse is discussing basic cardiac hemodynamics and explains preload to the client. What nursing intervention will decrease preload?
administration of a vasodilating drug
The nurse is discussing cardiac hemodynamics with a nursing student. The nurse explains preload to the student and then asks the student what nursing interventions might cause increased preload. Which response by the student indicates understanding?
application of antiembolic stockings (this helps with returning blood to the heart) **anything that assists with returning blood to the heart/preventing blood from pooling in the extremities will increase preload
The nurse working on a cardiac care unit is caring for a client whose stroke volume has increased. The nurse is aware that afterload influences a client's stroke volume. The nurse recognizes that afterload is increased when there is what?
arterial vasoconstriction
The nurse cares for a client with an intra-arterial blood pressure monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which condition?
catheter-related bloodstream infections
The nurse is caring for an acutely ill client who has central venous pressure monitoring in place. What intervention should be included in the care plan of a client with CVP in place?
change the site dressing whenever it becomes visibly soiled (helps to prevent infections)
A nurse is caring for a client with a central venous pressure (CVP) of 4 mm Hg. Which nursing intervention is appropriate?
continue to monitor the client as ordered (this CVP is within normal range)
The nurse is caring for a client newly diagnosed with sepsis. The client has a serum lactate concentration of 6 mmol/L and fluid resuscitation has been initiated. Which value indicates that the client has received adequate fluid resuscitation?
mean arterial pressure of 70 mmHg (want it > 65 mmHg)
A critically ill client is admitted to the ICU. The health care provider decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize?
perfusion distal to the insertion site *perform Allen's test prior to insertion
Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?
preload
Central venous pressure is measured in which heart chamber?
right atrium
Which term describes the amount of blood ejected per heartbeat?
stroke volume
