Hemo NURSING 4710

Hemo NURSING 4710 After receiving a handoff report from the night shift, the nurse completes the morning assessment of a patient with severe sepsis. Vital signs are: blood pressure 95/60 mm Hg, heart rate 110 beats/min, respirations 32 breaths/min, oxygen saturation (SpO2) 96% on 45% oxygen via Venturi mask, temperature 101.5° F, central venous pressure (CVP/RAP) 2 mm Hg, and urine output of 10 mL for the past hour. The nurse initiates which provider prescription first? a Increase supplemental oxygen therapy to maintain SpO2 greater than . 94%. b Administer infusion of 500 mL 0.9% normal saline every 4 hours as . needed if the CVP is less than 5 mm Hg. c Administer acetaminophen (Tylenol) 650-mg suppository per rectum as . needed to treat temperature greater than 101° F. d Administer 40 mg furosemide (Lasix) intravenous as needed if the urine . output is less than 30 mL/hr. 1 points QUESTION 21 The nurse is caring for a 70-kg patient in hypovolemic shock. Upon initial assessment, the nurse notes a blood pressure of 90/50 mm Hg, heart rate 125 beats/min, respirations 32 breaths/min, central venous pressure (CVP/RAP) of 3 mm Hg, and urine output of 5 mL during the past hour. Following physician rounds, the nurse reviews the orders and questions which order? a Administer acetaminophen 650-mg suppository prn every 6 hours for . pain. b Complete neurological assessment every 4 hours for the next 24 hours. . c Administer furosemide 20 mg IV every 4 hours for a CVP greater than or . equal to 20 mm Hg. d Titrate dopamine intravenously for blood pressure less than 90 mm Hg . systolic. 1 points QUESTION 22 The nurse is administering intravenous norepinephrine at 5 mcg/kg/min via a 20-gauge peripheral intravenous (IV) catheter. Which assessment finding requires immediate action by the nurse? a Blood pressure 100/60 mm Hg . b Swelling at the IV site . c Central venous pressure (CVP) of 8 . mm Hg d Heart rate of 110 beats/min . QUESTION 23 1 points The nurse is educating a patient’s family member about a pulmonary artery catheter (PAC). Which statement by the family member best indicates understanding of the purpose of the PAC? a “The catheter will provide multiple sites to give . intravenous fluid.” b “The catheter will allow the provider to better manage fluid . therapy.” c “The catheter tip comes to rest inside my brother’s . pulmonary artery.” d “The catheter will be in position until the heart has a . chance to heal.” 1 points QUESTION 24 1. The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, heart rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value requires immediate action by the nurse? a Systemic vascular resistance (SVR) of 1400 . dynes/sec/cm–5 b Cardiac output (CO) of 4 L/min . c . d Pulmonary vascular resistance (PVR) of 80 . dynes/sec/cm–5 1 points QUESTION 25 The nurse is caring for a patient in spinal shock. Vital signs include blood pressure 100/70 mm Hg, heart rate 70 beats/min, respirations 24 breaths/min, oxygen saturation 95% on room air, and an oral temperature of 94.8° F. Which intervention is most important for the nurse to include in the patient’s plan of care? a Administration of atropine sulfate . (Atropine) b Application of 100% oxygen via face . mask c Infusion of IV phenylephrine (Neo- . Synephrine) d Application of slow rewarming . measures 1 points A patient is admitted to the hospital with multiple trauma and extensive blood loss. The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min, respirations 36 breaths/min, cardiac output (CO) of 2 L/min, systemic vascular resistance of 3000 dynes/sec/cm–5, and a hematocrit of 20%. The nurse anticipates administration of which the following therapies or medications? a Dobutamine infusion . b Blood transfusion . c Dopamine hydrochloride . infusion d Furosemide . QUESTION 27 1 points The nurse is caring for a patient who has had an arterial line inserted. To reduce the risk of complications, what is the priority nursing intervention? a Ensure that all tubing connections are . tightened. b Obtain a portable x-ray to confirm . placement. c Apply a pressure dressing to the . insertion site. d Restrain the affected extremity for 24 . hours. 1 points QUESTION 28 The nurse is starting to administer a unit of packed red blood cells (PRBCs) to a patient admitted in hypovolemic shock secondary to hemorrhage. Vital signs include blood pressure 60/40 mm Hg, heart rate 150 beats/min, respirations 42 breaths/min, and temperature 100.6° F. What is the best action by the nurse? a Notify the physician of the elevated . temperature. b Administer blood transfusion over at least 4 . hours. c Titrate rate of blood administration to patient . response. d Notify the physician of the patient’s heart rate. . QUESTION 29 1 points The nurse is caring for a patient in cardiogenic shock experiencing chest pain. Hemodynamic values assessed by the nurse include a cardiac index (CI) of 2.5 L/min/m2, heart rate of 70 beats/min, and a systemic vascular resistance (SVR) of 2200 dynes/sec/cm−5. Upon review of physician orders, which order is most appropriate for the nurse to initiate? a Dobutamine infusion at a rate of 2 to 20 mcg/kg/min as needed for CI . less than 2 L/min/m2 b Nitroglycerin infusion titrated at a rate of 5 to 10 mcg/min as needed . for chest pain c Furosemide 20 mg intravenous (IV) every 4 hours as needed for CVP . greater than or equal to ≥20 mm Hg d Dopamine infusion at a rate of 5 to 10 mcg/kg/min to maintain a . systolic BP of at least 90 mm Hg 1 points QUESTION 30 The nurse is caring for a patient in cardiogenic shock who is being treated with an infusion of dobutamine. The physician’s order calls for the nurse to titrate the infusion to achieve a cardiac index of greater than or equal to 2.5 L/min/m2. The nurse measures a cardiac output, and the calculated cardiac index for the patient is 4.6 L/min/m2. What is the best action by the nurse? a Obtain a stat serum potassium . level. b Order a stat 12-lead . electrocardiogram. c Assess the patient’s hourly urine . output. d Reduce the rate of dobutamine. .