Critical Care HESI Exam

A client recovering from a percutaneous coronary intervention (PCI) after an acute myocardial infarction is being transferred from the PACU to the Cardiac ICU. Which assessment finding should the PACU nurse inform the healthcare provider of immediately? a. onset of chest pain b. need to apply pressure dressing c. presence of occasional PVCs d. absence of any urinary output during PACU stay - Answer- a. onset of chest pain This suggests the onset of another MI and reocclusion of a vessel. What is the preferred treatment of an acute MI within 12 hours of symptom onset? - Answer- PCI; places a stent in the affected coronary artery How often must a PCI pressure dressing site be assessed? - Answer- q30min for 4 hours qh thereafter Central Venous Pressure (CVP) - Answer- the pressure of blood in the thoracic vena cava, near the right atrium of the heart; reflects the amount of blood returning to the heart and the ability of the heart to pump the blood into the arterial system; normal is 2-6 mmHg Sensitivity of a pacemaker - Answer- pacing devices ability to detect what electrical activity is being generated by the patient's heart to prevent any competition between the hearts intrinsic activity Contrast Induced Nephropathy (CIN) - Answer- A sudden deterioration in renal function that is caused by intravascular administration of iodinated contrast medium; typically seen with angiplasty/angiography Signs of tension pneumothorax - Answer- 1. affected side will have decreased or absent lung sounds 2. cyanosis 3. Tracheal deviation (late sign) 4. distended neck veins 5. tachycardia, tachypnea Pneumatic Antishock Garment - Answer- An inflatable device that covers the legs and abdomen; used to splint the lower extremities or pelvis, or to control bleeding in the lower extremities or pelvis. - used for intraperitoneal hemorrhage What is the expected ABG of a pulmonary embolism? - Answer- Tachypnea and tachycardia-- respiratory alkalosis