Fluid overload Show Urticaria Explanation (pg 1642) What data are used to calculate stroke volume (SV) for a patient with arterial pressure-based cardiac output (APCO) monitoring? Height, BMR, age, gender Gender, age, height, weight BMI, BMR, blood pressure, heart rate Age, gender, blood pressure, heart rate PaO2 of 38 mm Hg, serum lactate level of 46.5 mcg/dL, and bleeding from puncture sites Explanation The nurse is evaluating a patient for the presence of systemic inflammatory response (SIRS). Which assessment data indicates the presence of SIRS? A patient with multisystem trauma has been in the ICU for 6 days after sustaining a closed head injury, a right sided pneumothorax, right rib fractures, a grade IV liver laceration, a pancreatic contusion, and a right acetabular fracture. The patient is still intubated and mechanically ventilated and has a chest tube, foley catheter, and two abdominal drains. The patient's hemodynamic assessment reveals the following values: BP, 94/66 mmHg;
HR, 118 beats/min; T, 38.7C; CVP, 5 cm H20; cardiac index, 6.1; and systemic vascular resistance, 450 dynes/sec. What is the most likely cause of this hemodynamic picture? 1. Monitor heart rate and blood pressure. Doubutamine is a sympathomimetic medication. When used in therapy with dobutamine, the patient's heart rate and blood pressure should be continuously monitored, as they may worsen hypotension, requiring the addition of a vasopressor. The infusion should be stopped if tachydysrhythmias develop. The administration through a central line is recommended, because infiltration leads to tissue sloughing. The drug should not be administered with sodium bicarbonate, because it can get deactivated. Because dobutamine is not adsorbed in plastic containers, it is not necessary to administer the drug in glass bottles. Test-Taking Tip: Key words or phrases in the stem of the question such as first, primary, early, or best are important. Similarly, words such as only, always, never, and all in the alternatives are frequently evidence of
a wrong response. As in life, no real absolutes exist in nursing; however, every rule has its exceptions, so answer with care. Anxiety The early presentation of a patient with cardiogenic shock is similar to that of a patient with acute decompensated heart failure (HF). The patient may have tachycardia. Signs of peripheral hypoperfusion (e.g., cyanosis, pallor, diaphoresis, weak peripheral pulses, cool and clammy skin, delayed capillary refill) occur. Decreased renal blood flow results in sodium and water retention and decreased urine output. Anxiety, confusion, and agitation may develop with impaired cerebral perfusion. The patient may have hypotension, not hypertension. What laboratory finding is consistent with cardiogenic shock?Patients with cardiogenic shock usually have a low cardiac index (<2.2 L/min/m2) and elevated ventricular filling pressures (ie, pulmonary capillary wedge pressure [PCWP] >15 mmHg and/or central venous pressure [CVP] >10 mmHg), and a decreased mixed venous oxygen saturation (table 1) [2-4].
Which clinical finding is commonly associated with patients in cardiogenic shock?The most common clinical manifestations of shock, such as hypotension, altered mental status, oliguria, and cold, clammy skin, can be seen in patients with cardiogenic shock.
Which medical diagnosis would the nurse suspect as the cause of cardiogenic shock?End-stage cardiomyopathy. The inability of the heart to pump enough blood for the systems causes cardiogenic shock.
Which condition does a patient with cardiogenic shock typically experience?Cardiogenic shock is a life-limiting condition that happens suddenly when your heart can't pump enough blood to keep up with your body's demand for it. A heart attack is the most common cause of cardiogenic shock. Without oxygen, your cells can't function and can die. This can lead to organ failure and be fatal.
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Which laboratory finding would the nurse expect to see in a patient with cardiogenic shock Quizlet
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