The nurse observes that the patient's jugular veins distend in the semi-upright position to more than 5 cm above the sternal angle. This is an indication of: - fluid volume overload. what is normal Pulmonary artery occlusion pressure (PAOP)? - 5-12 mmHg The resistance against which the left ventricle must pump to eject its volume is: - systemic vascular resistance. When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: - right ventricle. Tachycardia is dangerous for the patient with ischemic heart disease because of: - compromised cardiac output. During initial examination of a critical care patient, the nurse observes wide and convex nails and bulbous fingertips. This is evidence of: - central cyanosis. Priorities for palpation of the patient with cardiovascular disease include: - estimating edema. checking capillary refill checking for DVT arterial pulses By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme inhibitors produce: - b. vasodilation. The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus and atrioventricular node conduction and terminate supraventricular tachycardias in the patient at this time. The nurse will anticipate orders for which medications? - a. Verapamil, diltiazem, or amlodipine The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration of the drug, the nurse will assess for: - a. increased heart rate. The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - c. atrium is being paced. The possibility of microshock when handling a temporary pacemaker can be minimized by: - b. insulating the ends of the wires. and wearing gloves when handling the pacing wires In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac output is: - a. reduced preload. A patient is being monitored by continuous electrocardiogram (ECG) after placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may correct this situation? - a. Position the patient on the left side. or reposition the leads In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's heart rate is 70 beats/min. This phenomenon is reflective of - b. pacing artifact; the pacemaker is sensing and capturing. Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure (MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - b. 80 mm Hg What procedure secures an arteriovenous malformation when a pt's condition is too unstable for surgery? - embolization that can be done to secure the lesion without surgery. When the condition is more stable, an operation might be considered if needed. Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of the following? - a. Cerebrovascular dilation The nurse's priority in eye care for the patient in a coma will be: - c. keeping the eyes moist to prevent corneal ulceration. The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the patient's history, the nurse will: - perform a blood glucose measurement. The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will need to have the imbalance of which electrolyte corrected as soon as possible? - Sodium Which of the following conditions occurs when the renal tubules are unable to reabsorb excess glucose? - Glycosuria The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dL, his highdensity lipoprotein (HDL) cholesterol level is 32 mg/dL, and his fasting plasma glucose level is 224 mg/dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse recognizes the characteristics of: - metabolic syndrome. To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: - fluids The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate orders for the administration of: - vasopressin In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: - dilutional hyponatremia, reducing sodium concentration to critically low levels. Which assessment findings would indicate fluid volume excess? - edema, auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level is less than 25 mg/dL. To fully understand the patient's renal status, the nurse must consider this value along with: - c. creatinine level. To determine whether edema in a patient's hands is due to circulatory compromise or another cause, the nurse might: - elevate the patient's extremities for 1 hour and observe the degree of edema still present. Hypovolemia causes tachycardia and : - hypotension. To avoid the complications that can result from administering furosemide (Lasix) to stimulate urinary output, the nurse will carefully monitor: - levels of electrolytes, especially potassium. Which dialysis method would be most appropriate for the hemodynamically stable patient in the anuric phase of acute kidney injury (AKI)? - Intermittent hemodialysis What are complications of continuous renal replacement therapy (CRRT)? - Air embolism, decreased inflow pressure, electrolyte imbalance Which electrolytes pose the most potential hazard if not within normal limits for the person with acute kidney failure? - Potassium and calcium peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: - d. hyperkalemia. A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine output averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is the probable cause of this patient's acute kidney injury (AKI)? - Left ventricular failure causing prerenal AK