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The nurse is doing discharge teaching with a patient who has coronary artery disease. The patient asks why he has to take an aspirin every day if he doesnt have any pain. What would be the nurses best response?
- A. Taking an aspirin every day is an easy way to help restore the normal function of your heart
- B. An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks
- C. Taking an aspirin every day is a simple way to make your blood penetrate your heart more freely
- D. An aspirin a day eventually helps your blood carry more oxygen that it would otherwise
Correct Answer: B
Rationale: An aspirin a day is a common nonprescription medication that improves outcomes in patients with CAD due to its antiplatelet action. It does not affect oxygen carrying capacity or perfusion. Aspirin does not restore cardiac function.
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The critical care nurse is caring for a patient who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring procedure to assess the patients left ventricular function?
- A. Central venous pressure (CVP) monitoring
- B. Pulmonary artery pressure monitoring (PAPM)
- C. Systemic arterial pressure monitoring (SAPM)
- D. Arterial blood gases (ABG)
Correct Answer: B
Rationale: PAPM is used to assess left ventricular function. CVP is used to assess right ventricular function; SAPM is used for continual assessment of BP. ABG are used to assess for acidic and alkalotic levels in the blood.
The critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. The nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function. What is an additional function of pulmonary artery pressure monitoring systems?
- A. To assess the patients response to fluid and drug administration
- B. To obtain specimens for arterial blood gas measurements
- C. To dislodge pulmonary emboli
- D. To diagnose the etiology of chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Pulmonary artery pressure monitoring is an important tool used in critical care for assessing left ventricular function (cardiac output), diagnosing the etiology of shock, and evaluating the patients response to medical interventions, such as fluid administration and vasoactive medications. Pulmonary artery monitoring is preferred for the patient with heart failure over central venous pressure monitoring. Arterial catheters are useful when arterial blood gas measurements and blood samples need to be obtained frequently. Neither intervention is used to clear pulmonary emboli.
The nurse is caring for a patient who has central venous pressure (CVP) monitoring in place. The nurses most recent assessment reveals that CVP is 7 mm Hg. What is the nurses most appropriate action?
- A. Arrange for continuous cardiac monitoring and reposition the patient
- B. Remove the CVP catheter and apply an occlusive dressing
- C. Assess the patient for fluid overload and inform the physician
- D. Raise the head of the patients bed and have the patient perform deep breathing exercise, if possible
Correct Answer: C
Rationale: The normal CVP is 2 to 6 mm Hg. Many problems can cause an elevated CVP, but the most common is due to hypervolemia. Assessing the patient and informing the physician are the most prudent actions. Repositioning the patient is ineffective and removing the device is inappropriate.
The critical care nurse is caring for a patient with a central venous pressure (CVP) monitoring system. The nurse notes that the patients CVP is increasing. Of what may this indicate?
- A. Psychosocial stress
- B. Hypervolemia
- C. Dislodgment of the catheter
- D. Hypomagnesemia
Correct Answer: B
Rationale: CVP is a useful hemodynamic parameter to observe when managing an unstable patients fluid volume status. An increasing pressure may be caused by hypervolemia or by a condition, such as heart failure, that results in decreased myocardial contractility. Stress, dislodgement of the catheter, and low magnesium levels would not typically result in increased CVP.
A critical care nurse is caring for a patient with a hemodynamic monitoring system in place. For what complications should the nurse assess? Select all that apply.
- A. Pneumothorax
- B. Infection
- C. Atelectasis
- D. Bronchospasm
- E. Air embolism
Correct Answer: A,B,E
Rationale: Complications from use of hemodynamic monitoring systems are uncommon, but can include pneumothorax, infection, and air embolism. Complications of hemodynamic monitoring systems do not include atelectasis or bronchospasm.