Chapter 31 Osborn, Medical-Surgical Nursing, 2e

Question 1 Type: MCSA The nurse is in orientation for a new job caring for patients in the intensive care area. Which statement indicates to the preceptor that the new nurse needs more information about hemodynamic monitoring? 1. “Data from hemodynamic monitoring can be used to evaluate the patient’s progress.” 2. “Hemodynamic monitoring data can help to guide fluid administration and prevent fluid overload.” 3. “Hemodynamic monitoring data can be used to aid in the diagnosis of lung disorders.” 4. “One drawback of hemodynamic monitoring is that the catheter must go through the heart and into the pulmonary artery.” Correct Answer: 4 Rationale 1: One of the purposes of hemodynamic monitoring is evaluating patient response to therapy. Rationale 2: One of the purposes of hemodynamic monitoring is guiding therapy to minimize or correct dysfunction. Rationale 3: Hemodynamic monitoring can help to diagnose and treat a number of disorders, including disorders of the lung.Rationale 4: The pulmonary artery catheter does go through the heart and into the pulmonary artery; however, hemodynamic monitoring can also be accomplished through a peripheral arterial line. Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 31-1 Question 2 Type: MCSA A family member of a critically ill patient is verbalizing the purpose of hemodynamic monitoring. Which statement indicates that the family member needs more education? 1. “The hemodynamic monitor can measure how much blood is in the arteries and veins.” 2. “The hemodynamic monitor can measure how much blood comes out of the heart each minute.” 3. “The hemodynamic monitor can measure how much oxygen is left in the blood after it circulates through the body.” 4. “The hemodynamic monitor can measure how much pressure is in the heart.” Correct Answer: 1 Rationale 1: The pressure monitoring can see trends in pressure, which may indirectly be related to volume or to decreased vascular resistance. The nurse and physician would need to interpret this data to determine the cause of the change. Rationale 2: An example of such a measurement is thermodilution cardiac output. Rationale 3: An example of such a measurement is continuous mixed venous oxygen saturation.Rationale 4: An example of such a measurement is pulmonary artery occlusion pressure (PAOP), an indirect measurement of left ventricular end-diastolic pressure. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 31-1