Question 1

The nurse is caring for a patient whose pulmonary artery wedge pressure (PAWP)is 16 mmHg.The patient's neck veins are distended,lungs have crackles,and an S4 gallop is audible.Which intervention would the nurse anticipate?

Accepted Answer

The patient's symptoms suggest that he is experiencing left-sided heart failure, which is commonly treated with diuretics and vasodilators. Administering a fluid bolus or repeating the reading would not address the underlying issue and could even worsen the patient's condition. Repositioning the patient may provide temporary relief, but it is not a definitive treatment for heart failure. Therefore, the best intervention would be to administer a diuretic and a vasodilator to decrease the patient's pulmonary artery pressure and improve cardiac output.

Question 2

The preceptor nurse is assisting a newly hired nurse with completion of hemodynamic assessment using a pulmonary artery catheter.Which action would require the preceptor to intervene?

Accepted Answer

Infusing a vasoactive drug through the proximal injectate port of a pulmonary artery catheter is not recommended because it can lead to inaccurate hemodynamic measurements and potential harm to the patient. Vasoactive drugs should be administered through a dedicated central line to ensure proper dosage and effect.

Question 3

Which nursing actions are necessary to collect information needed to figure the patient's cardiac index? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The cardiac index is calculated using the formula: Cardiac Output (CO) divided by Body Surface Area (BSA). To determine BSA, the patient's weight and height are needed.

Question 4

A patient who has a pulmonary artery catheter in place is to receive the drug nitroprusside (Nipride).The nurse would assess for which indicator of the drug's effectiveness?

Accepted Answer

Nitroprusside (Nipride) is a vasodilator that will increase peripheral blood flow and decrease systemic vascular resistance. This will lead to a decrease in blood pressure and improved cardiac output in patients with heart failure or hypertension. A decrease in systemic vascular resistance would be the best indicator of nitroprusside's effectiveness in improving cardiac function. The other options (B, C, and D) are not expected outcomes of nitroprusside therapy and may indicate worsening of the patient's condition.

Question 5

A patient is being prepared for impedance cardiography.Which information will the nurse provide?

Accepted Answer

Impedance cardiography involves placing electrodes on the neck and lateral chest to measure changes in electrical resistance caused by the movement of blood through the cardiovascular system. A catheter is not typically used in this type of procedure, and ultrasound is not utilized to measure heart rate and blood flow. Measures of oxygenation of peripheral tissues may be obtained with other types of monitoring, but this is not relevant to impedance cardiography.

Question 6

While assisting with insertion of a central line,the nurse notes bright red blood flashing back into the tubing.The physician inserting the device removes it immediately.Which nursing action is indicated?

Accepted Answer

Applying direct pressure to the insertion site is the immediate nursing action indicated to prevent excessive bleeding and potential hematoma formation after the removal of the central line device.

Question 7

The nurse is performing an assessment on a patient whose right atrial pressure is 12 mmHg.Which findings would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A right atrial pressure of 12 mmHg indicates fluid overload in the right side of the heart and may lead to backup of blood in the venous system. Jugular vein distention and hepatomegaly are common findings in patients with fluid overload. Weak, thready pulse, rales and rhonchi, and poor skin turgor are not directly related to right atrial pressure and are therefore incorrect choices.

Question 8

While caring for a patient being hemodynamically monitored,the nurse notices that the systemic vascular resistance has risen to 1800 dynes/sec/cm⁵,whereas the patient's cardiac output remains at 6 liters per minute.What would the nurse expect the patient's blood pressure to be?

Accepted Answer

Increased systemic vascular resistance (SVR) leads to increased afterload, which can result in higher blood pressure, assuming cardiac output remains constant.

Question 9

A patient is admitted to the emergency department after fainting.Vital signs are blood pressure 86/60,heart rate 160 bpm,and respirations 20.The patient's skin is cool to the touch.The nurse suspects which underlying problem?

Accepted Answer

The patient's low blood pressure, high heart rate, and cool skin suggest decreased cardiac output. The other options do not fully explain all the vital sign abnormalities and skin changes observed.

Question 10

The nurse is assessing a patient's arterial waveform and notes a notch on the descending portion of the waveform.The nurse associates this notch with which physiological events? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The notch on the descending portion of the arterial waveform, known as the dicrotic notch, is associated with the closure of the aortic valve (A) and the beginning of ventricular diastole (E). This notch represents a brief increase in arterial pressure following the closure of the aortic valve due to the elastic recoil of the aorta, which momentarily increases the blood pressure before it continues to fall during diastole.

Question 11

A patient is admitted for evaluation of hypotension.Which assessment by the nurse would require immediate attention?

Accepted Answer

A pulmonary artery wedge pressure (PAWP) of 2 mmHg is significantly lower than the normal range (6-12 mmHg), indicating potential severe intravascular volume depletion or cardiogenic shock, which requires immediate attention to prevent further hemodynamic compromise.

Question 12

The nurse is caring for a patient with sepsis.On completing the hemodynamic assessment,the nurse notes that the patient's afterload,measured by the systemic vascular resistance,is 400 dynes/sec/cm^-5.The nurse evaluates this finding to be primarily the result of which change associated with sepsis?

Accepted Answer

Sepsis is associated with marked vasodilation, which can lead to decreased systemic vascular resistance and decreased afterload.

Question 13

The nurse is reviewing the results of a patient's cardiac output curve and notes that the size of the curve is small.Which of the following does this finding indicate?

Accepted Answer

The answer of The nurse is reviewing the results of...

Question 14

A patient who has a radial artery catheter in place is complaining of numbness and tingling in the fingers.What is the nurse's priority assessment?

Accepted Answer

The priority assessment in this situation is to determine if there is obstruction of blood flow distal to the catheter. This can be assessed by checking for a palpable pulse in the affected fingers. If there is no pulse, the catheter may be blocking blood flow and immediate action is needed.

Question 15

While evaluating a patient's pulmonary artery waveforms,the nurse notes a sudden onset of right ventricular waves.Which nursing intervention is indicated?

Accepted Answer

Sudden onset of right ventricular waves could indicate a pulmonary embolism or a right ventricular infarction, which require immediate medical attention. Therefore, notifying the physician for repositioning or further evaluation is the best nursing intervention. The other options may not be effective or appropriate in this situation.

Question 16

A patient who was stabbed multiple times in the chest and abdomen has just returned from emergency surgery.Hemodynamic monitoring was initiated during surgery and now reveals that the patient's right atrial pressure has dropped to 2 mmHg.The nurse would assess for findings of which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A drop in right atrial pressure can indicate a decrease in the volume of blood returning to the heart, which could be due to internal hemorrhage (A), fluid loss during surgery (B), or vasodilation from drugs administered during surgery (C). Left heart failure (D) and cardiac tamponade (E) typically cause an increase in right atrial pressure, not a decrease.

Question 17

The nurse is caring for a patient who is being monitored with a pulmonary artery catheter.Which change requires immediate intervention?

Accepted Answer

The spontaneous development of a pulmonary artery wedge pressure waveform indicates that the catheter has migrated and is wedged, which can lead to pulmonary infarction if not addressed immediately.

Question 18

A patient with congestive heart failure is receiving scheduled doses of an intravenous diuretic.After administering the drug,which finding would indicate to the nurse that the drug was effective?

Accepted Answer

A right atrial pressure of 5 mmHg indicates effective reduction of fluid volume and pressure in the heart, which is a goal in treating congestive heart failure with diuretics. Lower right atrial pressure suggests reduced preload and less stress on the heart, which is beneficial in heart failure management.

Question 19

The nurse is preparing to use the intermittent fluid bolus thermodilution method to obtain the patient's cardiac output via the pulmonary artery (PA)catheter.Which nursing action is indicated?

Accepted Answer

Zeroing the transducer at the phlebostatic axis ensures accurate pressure readings, which is crucial for obtaining correct cardiac output measurements.

Question 20

Which nursing interventions are indicated when measuring pulmonary artery wedge pressure (PAWP)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

- A) Using a volume of no more than 1.25 mL to inflate the balloon is correct because it minimizes the risk of overdistension and potential rupture of the pulmonary artery.- E) If there is any resistance during inflation, do not continue is correct because encountering resistance may indicate that the catheter is against a vessel wall or in a position where further inflation could cause damage.

Quiz 8: Basic Hemodynamic Monitoring

The nurse is caring for a patient whose pulmonary artery wedge pressure (PAWP) is 16 mmHg.The patient's neck veins are distended,lungs have crackles,and an S4 gallop is audible.Which intervention would the nurse anticipate?

The preceptor nurse is assisting a newly hired nurse with completion of hemodynamic assessment using a pulmonary artery catheter.Which action would require the preceptor to intervene?

Which nursing actions are necessary to collect information needed to figure the patient's cardiac index? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient who has a pulmonary artery catheter in place is to receive the drug nitroprusside (Nipride) .The nurse would assess for which indicator of the drug's effectiveness?

A patient is being prepared for impedance cardiography.Which information will the nurse provide?

While assisting with insertion of a central line,the nurse notes bright red blood flashing back into the tubing.The physician inserting the device removes it immediately.Which nursing action is indicated?

The nurse is performing an assessment on a patient whose right atrial pressure is 12 mmHg.Which findings would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

While caring for a patient being hemodynamically monitored,the nurse notices that the systemic vascular resistance has risen to 1800 dynes/sec/cm⁵,whereas the patient's cardiac output remains at 6 liters per minute.What would the nurse expect the patient's blood pressure to be?

A patient is admitted to the emergency department after fainting.Vital signs are blood pressure 86/60,heart rate 160 bpm,and respirations 20.The patient's skin is cool to the touch.The nurse suspects which underlying problem?

The nurse is assessing a patient's arterial waveform and notes a notch on the descending portion of the waveform.The nurse associates this notch with which physiological events? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient is admitted for evaluation of hypotension.Which assessment by the nurse would require immediate attention?

The nurse is caring for a patient with sepsis.On completing the hemodynamic assessment,the nurse notes that the patient's afterload,measured by the systemic vascular resistance,is 400 dynes/sec/cm^-5.The nurse evaluates this finding to be primarily the result of which change associated with sepsis?

The nurse is reviewing the results of a patient's cardiac output curve and notes that the size of the curve is small.Which of the following does this finding indicate?

A patient who has a radial artery catheter in place is complaining of numbness and tingling in the fingers.What is the nurse's priority assessment?

While evaluating a patient's pulmonary artery waveforms,the nurse notes a sudden onset of right ventricular waves.Which nursing intervention is indicated?

The nurse is caring for a patient who is being monitored with a pulmonary artery catheter.Which change requires immediate intervention?

A patient with congestive heart failure is receiving scheduled doses of an intravenous diuretic.After administering the drug,which finding would indicate to the nurse that the drug was effective?

The nurse is preparing to use the intermittent fluid bolus thermodilution method to obtain the patient's cardiac output via the pulmonary artery (PA) catheter.Which nursing action is indicated?

Which nursing interventions are indicated when measuring pulmonary artery wedge pressure (PAWP) ? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Quiz 8: Basic Hemodynamic Monitoring

The nurse is caring for a patient whose pulmonary artery wedge pressure (PAWP) is 16 mmHg.The patient's neck veins are distended,lungs have crackles,and an S4 gallop is audible.Which intervention would the nurse anticipate?

The preceptor nurse is assisting a newly hired nurse with completion of hemodynamic assessment using a pulmonary artery catheter.Which action would require the preceptor to intervene?

Which nursing actions are necessary to collect information needed to figure the patient's cardiac index? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient who has a pulmonary artery catheter in place is to receive the drug nitroprusside (Nipride) .The nurse would assess for which indicator of the drug's effectiveness?

A patient is being prepared for impedance cardiography.Which information will the nurse provide?

While assisting with insertion of a central line,the nurse notes bright red blood flashing back into the tubing.The physician inserting the device removes it immediately.Which nursing action is indicated?

The nurse is performing an assessment on a patient whose right atrial pressure is 12 mmHg.Which findings would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

While caring for a patient being hemodynamically monitored,the nurse notices that the systemic vascular resistance has risen to 1800 dynes/sec/cm5,whereas the patient's cardiac output remains at 6 liters per minute.What would the nurse expect the patient's blood pressure to be?

A patient is admitted to the emergency department after fainting.Vital signs are blood pressure 86/60,heart rate 160 bpm,and respirations 20.The patient's skin is cool to the touch.The nurse suspects which underlying problem?

The nurse is assessing a patient's arterial waveform and notes a notch on the descending portion of the waveform.The nurse associates this notch with which physiological events? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient is admitted for evaluation of hypotension.Which assessment by the nurse would require immediate attention?

The nurse is caring for a patient with sepsis.On completing the hemodynamic assessment,the nurse notes that the patient's afterload,measured by the systemic vascular resistance,is 400 dynes/sec/cm-5.The nurse evaluates this finding to be primarily the result of which change associated with sepsis?

The nurse is reviewing the results of a patient's cardiac output curve and notes that the size of the curve is small.Which of the following does this finding indicate?

A patient who has a radial artery catheter in place is complaining of numbness and tingling in the fingers.What is the nurse's priority assessment?

While evaluating a patient's pulmonary artery waveforms,the nurse notes a sudden onset of right ventricular waves.Which nursing intervention is indicated?

The nurse is caring for a patient who is being monitored with a pulmonary artery catheter.Which change requires immediate intervention?

A patient with congestive heart failure is receiving scheduled doses of an intravenous diuretic.After administering the drug,which finding would indicate to the nurse that the drug was effective?

The nurse is preparing to use the intermittent fluid bolus thermodilution method to obtain the patient's cardiac output via the pulmonary artery (PA) catheter.Which nursing action is indicated?

Which nursing interventions are indicated when measuring pulmonary artery wedge pressure (PAWP) ? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

While caring for a patient being hemodynamically monitored,the nurse notices that the systemic vascular resistance has risen to 1800 dynes/sec/cm⁵,whereas the patient's cardiac output remains at 6 liters per minute.What would the nurse expect the patient's blood pressure to be?

The nurse is caring for a patient with sepsis.On completing the hemodynamic assessment,the nurse notes that the patient's afterload,measured by the systemic vascular resistance,is 400 dynes/sec/cm^-5.The nurse evaluates this finding to be primarily the result of which change associated with sepsis?