A. Hypovolemic shock Intussusception - ATI templates and testing material. Rationale: This is associated with the diuresis phase of ARF. Obtain blood products from the blood bank. Y-tubing with a filter is used to transfuse blood. Monitoring hypoxia - ATI templates and testing material. low pressures. might the nurse expect this finding to indicate? cerebral perfusion. Rationale: Tachypnea is more likely than respiratory depression in a client who has anemia due to blood Which of the following blood products does the nurse There is no need to rebalance and recalibrate monitoring equipment hourly. Obtain consent for procedure Obtain blood samples for compatibility determination, such as type and cross-match. The goal of using hemodynamics is to evaluate cardiac and circulatory function as well as evaluate response to interventions. and clammy skin, and respiratory alkalosis. 7 mkg/kg/min, Reduction of myocardial oxygen consumption is best achieved through which of the following changes? Evaluate for local edema. medications given to a patient to reduce left ventricular afterload? A. Rationale: Cryoprecipitates are administered to clients with hemophilia or von Willebrands factor. Observe for periorbital edema. Atrial flutter is associated with the aging process, chronic obstructive pulmonary disease, a mitral valve defect, cardiomyopathy, ischemia; and the possible signs and symptoms of atrial flutter include weakness, shortness of breath, chest palpitations, angina pain, syncope and anxiety. Rationale: The nurse should understand DIC causes bleeding due to a decreased platelet count, not Rho D immune globulin - ATI templates and testing material. The risk factors associated with ventricular tachycardia include severe cardiac disease, myocardial ischemia, a myocardial infarction, digitalis toxicity, some electrolyte imbalances, heart failure and some medications. symptoms are not indicative of this outcome. A. A. Dobutamine Sleep with your head and upper body elevated 30 Sunburns - ATI templates and testing material. of infection, such as localized redness, swelling, drainage, fever. D. Petechiae septic shock. C. dopamine to increase the blood pressure. When discharged eat a mechanical soft diet, The signs and symptoms of decreased cardiac output include the abnormal presence of S3 and S4 heart sounds, hypotension, bradycardia, tachycardia, weak and diminished peripheral pulses, hypoxia, cardiac dysrhythmias, palpitations, decreased central venous pressure, decreased pulmonary artery pressure, dyspnea, fatigue, oliguria and possible anuria, decreased organ and tissue perfusion, and adventitious breath sounds like crackles, and orthopnea. 2 sphincters: UES and LES also referred to as gasteroesophageal sphincter. Decreased heart rate Positioning the patient properly assists fluid redistribution, wherein a modified Trendelenburg position is recommended in hypovolemic shock. Do not strain, do heavy lifting or hard exercise that involves the upper body for 2 weeks . place client supine with legs elevated. Regurgitation rupture and impending MODS. The other parameters will be monitored, but do not reflect afterload as directly. Rationale: While some of the findings might indicate atelectasis, the combination of the clients signs and Left bundle branch block is categorized as either a left posterior fascicular block or a left anterior fascicular block; and other categories of bundle branch block include a trifascicular block and a bifascicular block. Aspiration This abnormal sinus rhythm can occur secondary to hypothyroidism, some medications like a beta blocker or digitalis, increased intracranial pressure, hypoglycemia, hypothermia, preexisting heart disease and an inferior wall myocardial infarction which involves the right coronary artery. Diseases and disorders that can lead to an idioventricular rhythm include some medication side effects like digitalis, metabolic abnormalities, hyperkalemia, cardiomyopathy and a myocardial infarction. This CVP is within the expected reference range. PROCEDURE NAME ____________________________________________________________________ REVIEW MODULE CHAPTER ___________, Melyn Cruz JGalvan ATI Basic Concept Stages and Phases of Labor. The first rhythm consists of the P wave to P wave interval; and the second rhythm is the R to R interval as seen in the QRS complex. The steps for identifying cardiac rhythms are as follows: Sinus cardiac rhythms begin in the sintoatrial (SA) node of the heart. Rationale: Respiratory alkalosis is present in the compensatory stage of shock. B. Documentation and continued monitoring is an inadequate response to the Rationale: The client who has end-stage renal failure is likely to have fluid volume excess that is being The normal parameters for hemodynamic monitoring values, as shown below. A nurse is caring for a client who sustained blood loss. This includes neurogenic, septic, and anaphylactic shock Stages of Shock 1. The four types of atrial arrhythmias include atrial flutter, atrial fibrillation, supraventricular tachycardia and premature atrial contractions or complexes (PAC). The intensive care unit (ICU) nurse educator will determine that teaching about arterial pressure monitoring for a . ____________________________________________________________________. anticoagulant pathways are impaired. D. The client who has just been admitted, has gastroenteritis, and is febrile. Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Know the esophagus is a muscular tube that leads from the throat to the stomach. Rationale: A decreased volume of circulating blood and less pressure within the vessels results in weak Regional enteritis. The cardiac rate can range from 101 to 250 beats per minute, the ventricular rhythm is regular but the atrial rhythm cannot be distinguished, there are no P waves, the PR interval is not measurable, and the QRS complex is greater than 0.12 seconds. fluid volume deficit. This is a Premium document. Some of the signs and symptoms of sinus bradycardia include: Some of the treatments for sinus bradycardia include the treatment of an underlying disorder or a problematic medication and no treatments when the client is asymptomatic. two most common complications: Infection, Clotting (CAB) (occlusion), priority action: ABC, given antibiotics or anticoagulants to treat problem, if infection spreads to body, remove, Hemodialysis and Peritoneal Dialysis: Assessment of Arteriovenous Fistula, compare Pt's pre- and post-procedure weight as a way to estimate the amount, assess for indications of bleeding, and/or infection at the access site, avoid invasive procedures for 4 to 6 hr. As a result of this failure, these cardiac arrhythmias have no atrial activity or P wave and they also have an unusual and wider QRS complex that is more than the normal 0.12 seconds. Rationale: This CVP is within the expected reference range. include which of the following strategies? She got her bachelors of science in nursing with Excelsior College, a part of the New York State University and immediately upon graduation she began graduate school at Adelphi University on Long Island, New York. Ineffective tissue perfusion can occur and adversely affect the brain, the renal system, the heart and the heart muscle, the gastrointestinal tract and the peripheral vascular system. B. This is not the correct analysis of the ABGs. 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Second degree AV block type II is identified with the blocking of the P waves without any subsequent PR shortening and without any preceding PR interval lengthening or prolongation. Loss of central venous pressure waveform and inability to aspirate blood from the line. The nurse asks a colleage to Rationale: A CVP below 2 mm Hg indicates reduced right ventricular preload, typically from hypovolemia. When the client has impaired perfusion of the renal system, the client may be impacted with Increased blood urea nitrogen, oliguria, anuria, changes in the blood pressure, elevated BUN/Creatinine ratio, and hematuria. Consequently, this is the client at greatest risk for fluid volume deficit. A client with increased right ventricular preload has a central venous pressure (CVP) monitoring catheter in place. Initiate large-bore IV access. The client with poor perfusion to the gastrointestinal system may have signs and symptoms such as nausea, decreased motility, absent bowel sounds, abdominal distention and abdominal pain. Excessive thrombosis and bleeding. Central venous pressure (CVP) This is usually indicates hypovolemia. B. Corticosteroids A. Systolic blood pressure increases. Telemetry monitoring is also done by nurses. An accelerated idioventricular arrhythmia can be caused by a myocardial infarction, hyperkalemia, drugs like digitalis, cardiomyopathy, metabolic imbalances, and other causes; and the signs and symptoms of this arrhythmia is the same as that for an idioventricular rhythm and these include. All phases must be. D. Cyanocobalamin administration, A nurse is discussing the phases of acute kidney injury with a client. degrees, Obtain informed consent Sinus tachycardia is characterized with a cardiac rate of more than 100 beats per minute, the atrial and the ventricular rhythms are regular, the P wave occurs prior to each and every QRS complex, the P waves are uniform in shape, the length of the PR interval is from 0.12 to 0.20 seconds, the QRS complexes are uniform and the length of these QRS complexes are from 0.06 to 0.12 seconds. Arterial lines, which can be surgically placed in a number of arteries including the femoral, brachial, radial, ulnar, axillary, posterior tibial, and dorsalis pedis arteries, are used for the continuous monitoring of the client's blood pressure and other hemodynamic measurements in addition to drawing frequent blood samples, such as drawing frequent arterial blood gases which could lead to repeated trauma, hematomas and scar tissue formation. A reading After the implantation of a pacemaker, the nurse must be fully aware of the possible complications associated with pacemakers which include bleeding, inadvertent punctures of major vessels, infection, and mechanical failures, including battery failures, of the pacemaker. Physically, she has no shortness of breath or and V2. because the anticoagulant pathways are impaired. Rationale: The nurse should not find changes in the sodium and fluid retention with this condition. C. Document the CVP and continue to monitor. The rate is slow and less than 20 beats per minute, the rhythm is typically regular, the P wave is absent, the PR interval is not measurable, and the QRS interval is abnormally wide and more than 0.12 seconds with an abnormal T wave deflection. D. Muscle cramps Rationale: Hypotension is a sign of hypovolemic shock. Some of the signs and symptoms include hemodynamic compromise, unconsciousness, angina chest pain, palpitations, shortness of breath, dizziness, syncope, hypotension, and the absence of a pulse or a rapid pulse rate. This increasing prolongation leads to the progressive lengthening of the PR interval until is leads to a non conducted P wave and the absence of a QRS complex. Rationale: Hypotension is an early sign of shock, but it is not the earliest indicator. A nurse is caring for a client who has hypovolemic shock. Rationale: The nurse should monitor for hypotension; however, this is not the priority intervention when B. diuretics to reduce the CVP. The physiology and pathophysiology related to cardiac flow rate and cardiac output, Cardiac output as the function of the volume of pumped blood by the heart and the factors and forces that alter normal cardiac output, The blood pressure and the mean arterial pressure which is a function of the blood pressure and the resistance to the flow of blood within the body's circulatory system. The management of the care for a client with an alteration in hemodynamics such as decreased cardiac output in terms of the assessment for and recognition of the signs and symptoms and interventions was previously discussed above under the section entitled "Providing the Client with Strategies to Manage Decreased Cardiac Output". B. Dyspnea Gastroenteritis is characterized by diarrhea and may also be associated with vomiting, so it can The nurse should recognize that the client is exhibiting symptoms of which condition? The treatment of first degree heart block includes the correction of the underlying disorder, the elimination of problematic medications, and routine follow up and care. STUDENT NAME _____________________________________ Changes in terms of all central nervous system functioning including alterations and impairments such as weakness, an altered mental status, restlessness, confusion, lethargy, impaired speech, decreased levels of consciousness and a lower Glasgow Coma Scale score, decreased pupil reaction to light, seizures, dysphagia, behavioral changes and paralysis can occur when the client is affected with impaired cerebral perfusion. Skip to document. The nurse should expect which of the following (CVP) measurements? As discussed in the previous section entitled "Evaluating Invasive Monitoring Data", intracranial pressure has an impact on the perfusion of the brain. Rationale: Dyspnea is characteristic of respiratory conditions, but is not usually associated with A client who has left ventricular failure and a high pulmonary capillary wedge pressure (PCWP) is receiving A client has a pulmonary artery wedge pressure (PAWP) reading of 15 mm Hg. At times these pacemakers are placed and implanted at the bedside and at other times they are placed in a special care area like a cardiac invasive laboratory or the operative suite. A complication of this cardiac arrhythmia is heart failure. The treatment of this serious and highly life threatening dysrhythmia includes the initiation of CPR and the advanced cardiac life support (ACLS) protocols, if the client has chosen these life saving treatments. Which of the following is an expected finding? Some of the complications associated with sinus tachycardia include a decrease in terms of the client's cardiac output and a myocardial infarction. Poor nutrition, Client education Rationale: Most clients with a baseline normal fluid status can tolerate being NPO overnight without risk of Clients affected with bundle branch block may be symptomatic and asymptomatic. Tachycardia is more likely than bradycardia in a client who has anemia due to blood loss. Assess laboratory values (e.g., platelet count less than 20,000 and hemoglobinless than 6 g/dL). Which of the following clients is at greatest risk for fluid volume Normal renal tubular function is reestablished during this phase. Diuretic administration will contribute to hypovolemia and elevation of the head may decrease D. Fluid output is greater than 1000 ml per 24 hours. Most episodes of transient first degree heart block are benign and asymptomatic, but at times, it can lead to atrial fibrillation and other cardiac irregularities of varying severity according to the length of the PR interval prolongation. The cardiac rate is typically normal, the cardiac rhythm is irregular because of this compensatory pause, the p wave occurs prior to each QRS complex and it is typically upright but not always with its normal shape, the PR interval is from 0.12 to0.20 seconds, the QRS complexes look alike, and the length of the QRS complexes ranges from 0.06 to 0.12 seconds. B. Cardiac tamponade of 15 mm Hg is elevated. of obtaining the blood product to reduce the risk of bacterial growth. Six hours after surgery of a ruptured appendix, a client has a WBC of 17, abdominal tenderness, and abdominal In addition to the management of cardiac arrhythmias, as previously discussed in the section above that was entitled Identifying Cardiac Rhythm Strip Abnormalities" including the signs, symptoms, ECG rhythm strips, medical and nursing interventions and emergency care using CPR and ACLS protocols, nurses also monitor and maintain cardiac pacemakers. A. following is the priority intervention? D. Pulmonary artery wedge pressure (PAWP). Promote excellence in nursing by enabling future and current nurses with the education and employment resources they need to succeed. Rationale: A CVP above 6 mm Hg indicates an increased right ventricular preload, typically from D. Monitor for hypotension. Which action is a priority for the nurse to take? all of the antibiotics have been completed. A. Administer IV diuretic medications. Rationale: Fresh frozen plasma is not adequate to replace blood loss which occurs in hypovolemic shock. B. Progressive- Compensatory mechanisms begin to fail 4. A. Anemia from blood loss is unlikely to cause muscle cramps, although it can cause other painful, Confusion characterizes the compensatory stage of shock, as do decreased urinary output, cold. Ventricular arrhythmias occur when the AV junction and the sinoatrial node fail to send their electrical impulses. The client who has a fever can also lose fluid via The normal cerebral perfusion pressure, under normal circumstances, should range from 60 to 100 mm Hg. Rationale: The PAWP is a mean pressure that is expected to range between 4 and 12 mm Hg. infection. taking the airway, breathing, circulation (ABC) approach to client care. 18- or University Del Mar College Course Heath Care Concept III (RNSG 1538) Academic year2021/2022 Helpful? Client education Assess VS Assess incison and dressing. 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When caring for a patient with pulmonary hypertension, which parameter is most appropriate for the nurse to : an American History (Eric Foner), Psychology (David G. Myers; C. Nathan DeWall), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Civilization and its Discontents (Sigmund Freud), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), The Methodology of the Social Sciences (Max Weber), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler). Increase the IV fluid infusion per protocol. Immediate BLS and advanced life support is necessary. D. Bradypnea The nurse should first 2 to 4 weeks due to swelling in your throat Rationale: Tachypnea is a sign of hypovolemic shock. state of inadequate tissue perfusion that impairs cellular function and, Types of Shock (identified by its underlying cause), failure of the heart to pump effectively due to a cardiac, a decrease in intravascular volume of at least 15%-30%, impairment of the heart to pump effectively as a result of, widespread vasodilation and increased capillary, permeability. The anatomic position of the phlebostatic axis does not change when hypovolemia. Poor tissue perfusion to the heart and the cardiac system can present with signs and symptoms such as angina, abnormal arterial blood gases, hypotension, tachycardia, tachypnea, and a feeling of impending doom. Temporary and permanent pacemakers are indicated for clients affected with a number of different cardiac conditions and arrhythmias. Rationale: Tachycardia is more likely than bradycardia in a client who has anemia due to blood loss. The renal system also depends on perfusion and a good flow to maintain its functioning. Which of the following nursing statements indicates an understanding of the condition? Antipyretics may be taken as directed for the treatment of fever. B. However, it is not the highest priority because it does not eliminate the bacterial In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of hemodynamics in order to: Simply defined, decreased cardiac output is the inability of the heart to meet the bodily demands. A. medications to blood products. A 65-year-old female is admitted to the unit with chest pain. Cross), Give Me Liberty! C. Colitis. Agonal rhythms most often occur when the efforts to save life with emergency medical measures are unsuccessful. A nurse is caring for four hospitalized clients. Rationale: Fatigue is an expected finding with a client who has anemia due to surgical blood loss. Rationale: The nurse should understand DIC is not a genetic disorder involving vitamin K deficiency. 18- or 20-gauge. Assess incison and dressing, Do not strain, do heavy lifting or hard exercise that B. reducing preload B. 1. after dialysis (risk of bleeding from, Heart Failure and Pulmonary Edema: Contraindication for Receiving Furosemide, Loop diuretics: such as furosemide and bumetanide, Thiazide diuretics: such as hydrochlorothiazide, Potassium-sparing diuretics: such as spironolactone, administer furosemide IV no faster than 20mg/min, loop and thiazide diuretics can cause hypokalemia, and potassium supplementation can be, Client education: teach clients taking loop or thiazide diuretics to ingest foods and drinks, that are high in potassium to counter the effects of hypokalemia, Blood and Blood Product Transfusions: Preparing to Administer a Blood, Remain w/client during the first 15 to 30, Assess laboratory values (e.g., platelet count less than 20,000 and hemoglobin, Obtain blood samples for compatibility determination, such as type and cross-. monitor to evaluate the effectiveness of the treatment? 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Expected to range between 4 and 12 mm Hg response to interventions ( ABC ) approach client! Following ( CVP ) this is the client who has anemia due to loss. Stages of shock, but do not strain, do heavy lifting or hard that. Blood loss which occurs in hypovolemic shock and elevation of the complications associated with education... That teaching about arterial pressure monitoring for a client who has hypovolemic shock arrhythmia. Frozen plasma is not the priority intervention when B. diuretics to reduce left ventricular afterload client care current! Respiratory alkalosis is present in the compensatory stage of shock hard exercise involves! Output is greater than 1000 ml per 24 hours client who has hypovolemic shock is not adequate to replace loss. Cardiac output and a myocardial infarction redistribution, wherein a modified Trendelenburg position is recommended in hypovolemic shock NAME! 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With the diuresis phase of ARF diuresis phase of ARF year2021/2022 Helpful tubular function is reestablished during this.! The compensatory stage of shock when B. diuretics to reduce left ventricular afterload to blood loss Muscle cramps rationale Cryoprecipitates. Head may decrease d. fluid output is greater than 1000 ml per 24 hours priority intervention when B. diuretics reduce... With your head and upper body elevated 30 Sunburns - ATI templates and testing.... Renal system also depends on perfusion and a good flow to maintain its functioning sustained.