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Chapter 08: Hemodynamic Monitoring 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 cardiac index of 1.2 L/min/m3 combined with the identified clinical assessment findings ind...

Nurse plans to administer a dose of metoprolol at 0900 to a client with HTN. At 0800 nurse notestelemetry pattern shows second degree heart block with Ventricular rate of 50. Action Hold scheduled dose and notify HCP of telemetry pattern Nurse is reviewing client ECG and determines PR interval prolonged. Indicates Increased conduction time from the SA node to the AV junction When assessing a restless, intubated client on mechanical ventilation, nurse auscultates breath sounds onright side ...

Which is the BEST description of expected breath sounds heard during auscultation?1. Administer the Ceclor as ordered; do not administer the naproxen. 2. Administer the naproxen as ordered; do not administer the Ceclor. 3. Administer both the Ceclor and naproxen as ordered; document the client's response.4. Do not administer the Ceclor or naproxen; notify the healthcare provider. 3 - ANSWER-The nurse teaches a client about how to care for an ileostomy. Which comment, if made by the client...

Nurse plans to administer a dose of metoprolol at 0900 to a client with HTN. At 0800 nurse notes telemetry pattern shows second degree heart block with Ventricular rate of 50. Action Hold scheduled dose and notify HCP of telemetry pattern Nurse is reviewing client ECG and determines PR interval prolonged. Indicates Increased conduction time from the SA node to the AV junction When assessing a restless, intubated client on mechanical ventilation, nurse auscultates breath sounds on right sid...

How to calculate HR on EKG - ANSWERS big boxes: take 300 and divide by the number of boxes between RR Atrial Fibrillation - ANSWERS Rapid, random, ineffective *contractions of the atrium* No P Waves, *Normal QRS w/ irreg intervals* Risk for thrombi Tx: anti coagulants (Heparin), TEE, Synchronized Cardioversion Atrial Flutter - ANSWERS No P Waves, QRS at reg intervals Sawtooth or FLUTTER WAVES Tx: Anti coagulants, TEE, synchronized cardioversion Adenosine, beta blockers, calcium channel ...

A nurse is preparing to administer epinephrine 10 mcg/min by continuous IV infusion. Available is epinephrine 1 mg in 250 mL dextrose 5% in water (D5W). The nurse should set the IV pump to deliver how many mL/hr? Round to the nearest whole number. - ANSWERS150 A nurse is preparing to administer potassium chloride 40 mEq to infuse over 4 hr to a client. Available is potassium chloride 40 mEq in 100 mL dextrose 5 % in 0.45 % sodium chloride (Ds 0.45 % NaCl). The nurse should set the infusion...

A nurse is preparing to administer dobutamine 2.5 mcg/kg/min by continuous IV infusion to a client who weight 65 kg. The amount avaliable is dobutamine 250mg/250ml. The nurse should set the IV Pump to deliver how many ml/hr? - ANSWER 9.8 A nurse is preparing to administer nitroprusside 4 mcg/kg/min by continuous IV infusion to a client who weighs 57 kg. Avaliable is nitroprusside 50 mg in 250 ml dextrose 5% in water. The nurse should set the IV pump to deliver to deliver how many ml/hr? - ...

The nurse is providing postprocedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take? a. Notify the primary healthcare provider immediately b. Apply a warm, moist compress to the incision site c. Increase the intravenous fluid rate by 20 mL/hr d. Monitor vital signs more frequently b A nurse observes a window washer falling 25 feet (7.6 m) to the ground. The nurse rushes...

The nurse is providing postprocedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take? a. Notify the primary healthcare provider immediately b. Apply a warm, moist compress to the incision site c. Increase the intravenous fluid rate by 20 mL/hr d. Monitor vital signs more frequently b A nurse observes a window washer falling 25 feet (7.6 m) to the ground. The nurse rushes...

What assessment findings should he nurse document in the electronic medical record for a client who is experiencing autonomic dysreflexia after a T-4 spinal cord injury - Severe hypertension, diaphroresis, and flushing above the lesion 2 . As the nurse is turning a client with a chest tube, the chest tube becomes dislodged from the pleural space. What action should the nurse take first? - Have the client exhale forcefully and tape 3 sides of a sterile gauze over the insertion site 3 . The ...

. long history of smoking; sob; ABG pH7.25, PCO2 50, HCO3 24 respiratory acidosis (if CO2 is high it will always be resp. acidosis) 2."heart is pounding outside of her chest" client is in SVT; intervention coach client in relaxation and deep breathing in protocol; pt. insulin is infused at 5 units/hr and her current glucose reading is 165. what to do? increase drip by 1 unit/hr late; 1,500,000 IU in 500 mL of 0.9% NS 33 5.DKA math question 1000 mL NS with 30 mEq of sodium client com...

The nurses calculating fluid resuscitation for young adult male who was burned in a bloody accident at 1200 and is seen in the ER at 1400. The HCP determines that the client has burn over 30% of his body, mainly over his arms and chest. Using the Parkland formula for fluid resuscitation, the client is to receive 7000 mL of fluid in 24 hours. Which goal should the nurse establish for this clients plan of care? - ANSWER By 2000, the client will have received 3500 mL of fluid When caring for ...

The physician has ordered a norepinephrine drip at 8 mcg/min for a patient with hypotension. The norepinephrine concentration is 4 mg/250 mL D5W. How many milliliters per hour should the norepinephrine be infused? - ANSWER 30 A patient is receiving vasopressin at 12 mL/h. The vasopressin concentration is 4 mg/250 mL. How many micrograms per minute of vasopressin is the patient receiving? - ANSWER 3.2 The physician orders dopamine IV drip at 4 mcg/kg/min for low blood pressure. The patient...

Background of Critical Care Calculations - ANSWER Critical care medications can induce changes in BP and heart rate and require continuous monitoring Accurate calculations of dosages is essential Medications used in critical care can be ordered by dosage (mcg/ min/ kg/h; mcg/ kg/ h) We usually see these types of calculations when you are cardiac floors For these types of questions, it is really important to look at the question to see what it is you need to do EX. IF SOMETHING IS IN MINUT...

Parliament Consists of the elected House of Commons, the unelecteterm-46d House of Lords and the Monarch. What stages does a Bill go through on its way to becoming law? Bill may start either in the Commons or the Lords. First reading Second reading (debate and vote) Committee Stage Report Stage (Committee reports to the House) Third reading (debate and vote) All of the above repeated in the other House. Royal Assent The Bill then becomes an Act of Parliament. Judicial Precedent Law...

when was the first police created and by who? - ANSWER -1829 by Robert Peel what are the philosophy's and values of the police? - ANSWER - basic mission of police to prevent crime and disorder - honesty & integrity- they shouldn't compromise or abuse their position - equality & diversity- duty is to impartiality serve the law - physical force is a lay resort - police are the public, citizens pairs to ensure we all abide the laws what are the aims and objective of the police? - ANSWER - ...

Subpoena - ANSWER a legal document ordering a person to testify in a court of law as a witness Actus Reus - ANSWER The actual criminal act Mens Rea - ANSWER legal phrase used to describe the mental state a person must have been in while committing a crime for it to be intentional Loops - ANSWER the most common fingerprint Chain of Custody - ANSWER a process used to maintain and document the chronological history of evidence Nolo Contedere - ANSWER a plea of "no contest" that one could ...

In cleaning and sterilization process of instruments, final rinse refers to A. Final cleaning of instruments in detergents before they are placed in the sterilizer B. The final rinse cycle of the sterilizer C. Removing chemical residues and debris from instrument with deionized or reverse osmosis water D. Thoroughly cleaning the instruments with softened water - ANSWER- C. Removing chemical residues and debris from instrument with deionized or reverse osmosis water A molecular reaction th...

What do Case Managers do? - ANSWER Monitor high resource cases to ensure effective utilization What is HIM responsible for? - ANSWER all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? - ANSWER manage cases: services correct, on time What are the three types of utilization review? - ANSWER Prospective, Concurrent, Retrospective Where can home health services be offered? - ANSWER Home, Assist Livi...

When does a hospital add ambulance charges to the Medicare inpatient claim? - ANSWER- If the patient requires ambulance transportation to a skilled nursing facility How should a provider resolve a late-charge credit posted after an account is billed? - ANSWER- Post a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts - ANSWER- They are not being processed in a timely manner What is an advantage of a ...