The nurse is caring for a critically ill patient with end-stage liver disease.The nurse knows that the patient is at risk for hyperdynamic circulation and varices.Which of the following assessments would indicate a hyperdynamic status?
A) Jugular venous distension
B) Normal sinus rhythm on the cardiac monitor
C) Blood pressure of 180/90 mm Hg
D) Stools that are guaiac positive

Question

Quizplus · Accepted Answer

Portal hypertension causes two main clinical problems for the patient: hyperdynamic circulation and development of esophageal or gastric varices.Liver cell destruction causes shunting of blood and increased cardiac output.Vasodilation is also present (so vasodilators are not needed),which causes decreased perfusion to all body organs,even though the cardiac output is very high.This phenomenon is known as high-output failure or hyperdynamic circulation.Clinical signs and symptoms are those of heart failure and include jugular vein distension,pulmonary crackles,and decreased perfusion to all organs.Blood pressure decreases,and dysrhythmias are common.Guaiac-positive stools may be an indication of gastrointestinal bleeding.

The Nurse Is Caring for a Critically Ill Patient with End-Stage