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The nurse aware that a shortage of organs exists knows that which statement is true?
- A. Anyone who is comfortable approaching the family sh ould discuss the option of organ donation.
- B. Brain death determination is required before organs ca n be retrieved for transplant.
- C. Donation of selected organs after cardiac death is ethically acceptable.
- D. Family members should consider withdrawing life supapboirbrt.c osmo /ttehsat t the patient can become an organ donor.
Correct Answer: B
Rationale: Rationale for Correct Answer (B - Brain death determination is required before organs can be retrieved for transplant):
1. Brain death determination is a medical necessity to ensure the organs are viable for transplant.
2. Organs must be retrieved promptly after brain death to maintain their functionality.
3. Brain death criteria ensure that the donor is truly deceased before organ retrieval.
Summary of Why Other Choices are Incorrect:
A: While discussing organ donation is important, comfort level is not the main factor in organ shortage awareness.
C: Donation after cardiac death is ethically acceptable, but it is not directly related to the need for brain death determination.
D: Withdrawing life support solely to become an organ donor is ethically questionable and not a necessary step in organ donation.
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When monitoring the effectiveness of treatment for a patient with a large anterior wall myocardial infarction, the most important information for the nurse to obtain is:
- A. Central venous pressure (CVP).
- B. Systemic vascular resistance (SVR).
- C. Pulmonary vascular resistance (PVR).
- D. Pulmonary artery wedge pressure (PAWP).
Correct Answer: D
Rationale: The correct answer is D: Pulmonary artery wedge pressure (PAWP). This is crucial in monitoring a patient with a large anterior wall myocardial infarction as it provides information on left ventricular function and fluid status. A high PAWP may indicate left ventricular failure or fluid overload, requiring immediate intervention.
A: Central venous pressure (CVP) is not as specific for assessing left ventricular function and may not provide accurate information in this scenario.
B: Systemic vascular resistance (SVR) is important in assessing systemic blood flow, but it may not directly indicate left ventricular function in this case.
C: Pulmonary vascular resistance (PVR) is more relevant in conditions affecting the pulmonary circulation and may not be as immediately informative in assessing left ventricular function in this context.
While caring for a patient with a pulmonary artery cathete r, the nurse notes the pulmonary artery occlusion pressure (PAOP) to be significantly higher than previously recorded values. The nurse assesses respirations to be unlabored at 16 breat hs/min, oxygen saturation of 98% on 3 L of oxygen via nasal cannula, and lungs clear to auscultation bilaterally. What is the priority nursing action?
- A. Increase supplemental oxygen and notify respiratory therapy.
- B. Notify the physician immediately of the assessment fin dings.
- C. Obtain a stat chest x-ray film to verify proper catheter placement.
- D. Zero reference and level the catheter at the phlebostati
Correct Answer: B
Rationale: The correct answer is B: Notify the physician immediately of the assessment findings. The significantly higher PAOP could indicate a potential complication or a change in the patient's condition that needs immediate medical attention. By notifying the physician, further assessment and interventions can be initiated promptly to address the underlying cause. Increasing supplemental oxygen (choice A) may not directly address the elevated PAOP, obtaining a chest x-ray (choice C) may delay urgent intervention, and zero referencing the catheter (choice D) is not a priority in this situation. Notifying the physician ensures timely and appropriate management of the patient's condition.
The nurse caring for a mechanically ventilated patient prepares to include which strategies to prevent ventilator-associated pneumonia should be into the patient’s plan of care? (Select all that apply.)
- A. Drain condensate from the ventilator tubing away from the patient.
- B. Elevate the head of the bed 30 to 45 degrees.
- C. Instill normal saline as part of the suctioning procedure.
- D. Perform regular oral care with chlorhexidine.
Correct Answer: A
Rationale: The correct answer is A: Drain condensate from the ventilator tubing away from the patient. This is crucial to prevent ventilator-associated pneumonia as stagnant condensate can harbor harmful bacteria. By draining it away from the patient, the risk of bacterial growth and subsequent aspiration is minimized. Elevating the head of the bed (choice B) helps prevent aspiration but is not specific to preventing ventilator-associated pneumonia. Instilling normal saline during suctioning (choice C) can increase the risk of infection. Performing regular oral care with chlorhexidine (choice D) is important for oral hygiene but not directly related to preventing ventilator-associated pneumonia.
Continuous venovenous hemodialysis is used to
- A. remove fluids and solutes through the process of convection.
- B. remove plasma water in cases of volume overload.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection and dialysis
Correct Answer: D
Rationale: The correct answer is D because continuous venovenous hemodialysis combines ultrafiltration, convection, and dialysis techniques. Ultrafiltration removes excess fluid, convection helps in removing solutes, and dialysis involves the diffusion of solutes across a semipermeable membrane. This comprehensive approach ensures effective removal of both fluid and solutes in critically ill patients.
Incorrect Answer Analysis:
A: Removing fluids and solutes through convection alone is not the complete process in continuous venovenous hemodialysis.
B: While volume overload is addressed, continuous venovenous hemodialysis involves more than just removing plasma water.
C: Adding dialysate is not the primary method in continuous venovenous hemodialysis; it involves ultrafiltration, convection, and dialysis techniques.
The nurse is assigned to care for a patient who is a non-na tive English speaker. What is the best way to communicate with the patient and family to provide updates and explain procedures?
- A. Conduct a Google search on the computer to identify resources for the patient and family in their native language. Print these for their use .
- B. Contact the hospital’s interpreter service for someone to translate.
- C. Get in touch with one of the residents that you know is fluent in the native language and ask him if he can come up to the unit.
- D. Use a young family member who is fluent in both English and the native language to translate for you.
Correct Answer: B
Rationale: The correct answer is B: Contact the hospital’s interpreter service for someone to translate. This is the best option as it ensures accurate communication between the nurse, patient, and family. Hospital interpreters are trained professionals who can accurately convey medical information, ensuring understanding and informed decision-making. Using Google search (A) may result in inaccurate information and is not reliable for medical communication. Asking a resident (C) who is fluent may not guarantee accuracy in medical terminology. Using a young family member (D) as a translator can lead to miscommunication due to potential language barriers or lack of medical knowledge. Overall, option B is the most appropriate and ethical choice for effective communication in a healthcare setting.