types of shock cardiac ATI practice questions hypovolemic shock CVP Glasgow Coma A CVP below 2 mm Hg indicates reduced right ventricular preload, typically from hypovolemia. The definition of hemodynamics as the flow of blood as ejected from the heart to circulate throughout the body in order to effectively oxygenate the tissues of the body. They may also be at risk for accidents such as falls when the client with decreased cardiac output is affected with weakness, fatigue, confusion and other changes in terms of their level of consciousness and mental status. A. Tachycardia is more likely than bradycardia in a client who has anemia due to blood loss. Assessing the Client for Decreased Cardiac Output, Identifying Cardiac Rhythm Strip Abnormalities, Applying a Knowledge of Pathophysiology to Interventions in Response to Client Abnormal Hemodynamics, Providing the Client with Strategies to Manage Decreased Cardiac Output, Intervening to Improve the Client's Cardiovascular Status, Monitoring and Maintaining Arterial Lines, Managing the Care of a Client on Telemetry, Managing the Care of a Client Receiving Hemodialysis, Managing the Care of a Client With an Alteration in Hemodynamics, Tissue Perfusion and Hemostasis, Adult Gerontology Nurse Practitioner Programs (AGNP), Womens Health Nurse Practitioner Programs, Advanced Practice Registered Nurse (APRN), Performing and Managing the Care of the Client Receiving Dialysis, Identifying the Client with Increased Risk for Insufficient Vascular Perfusion, Physiological AdaptationPractice Test Questions, RN Licensure: Get a Nursing License in Your State, Assess client for decreased cardiac output (e.g., diminished peripheral pulses, hypotension), Identify cardiac rhythm strip abnormalities (e.g., sinus bradycardia, premature ventricular contractions [PVCs], ventricular tachycardia, fibrillation), Apply knowledge of pathophysiology to interventions in response to client abnormal hemodynamics, Provide client with strategies to manage decreased cardiac output (e.g., frequent rest periods, limit activities), Intervene to improve client cardiovascular status (e.g., initiate protocol to manage cardiac arrhythmias, monitor pacemaker functions), Manage the care of a client with a pacing device (e.g., pacemaker), Manage the care of a client receiving hemodialysis, Manage the care of a client with alteration in hemodynamics, tissue perfusion and hemostasis (e.g., cerebral, cardiac, peripheral), Make a conclusion about the cardiac rhythm on the rhythm strip, The normal sinus rhythm which has a cardiac rate of 60 to 100 beats per minute, Sinus bradycardia which has a cardiac rate of less than 60 beats per minute, Sinus tachycardia which has a cardiac rate of more than 100 beats per minute, A sinus arrhythmia which is an irregular heart rate that can range from 60 to 100 beats per minute, An idioventricular rhythm, also referred to as a ventricular escape rhythm, has a rate of less than 20 to 40 beats per minute, An accelerated idioventricular rhythm with more than 40 beats per minute, An agonal rhythm with less than 20 beats per minute, Ventricular tachycardia with more than 150 beats per minute, Second-Degree Atrioventricular Block, Type I, Second-Degree Atrioventricular Block, Type II. Assess for a history of blood-transfusion reactions. The most common causes of first degree heart block are an AV node deficit, a myocardial infarction particularly an inferior wall myocardial infarction, myocarditis, some electrolyte disorders, and medications like beta blockers, cardiac glycoside medications, calcium channel blockers and cholinesterase inhibitors. A. Hypovolemic shock A nurse is assessing a client who has disseminated intravascular coagulation (DIC). The first rhythm consists of the P wave to P wave interval; and the second rhythm is the R to R interval as seen in the QRS complex. (ABC) approach to client care. Rationale: This is associated with the recovery phase of ARF. A. Home / NCLEX-RN Exam / Hemodynamics: NCLEX-RN. She began her work career as an elementary school teacher in New York City and later attended Queensborough Community College for her associate degree in nursing. B. Rationale: The client should take his temperature every morning and evening until the infection resolves. Other hemodynamic findings include cardiac output of D. Cyanocobalamin administration, A nurse is discussing the phases of acute kidney injury with a client. Confusion Asystole occurs most frequently when ventricular fibrillation is not corrected, but it can also occur suddenly as the result of a myocardial infarction, an artificial pacemaker failure, a pulmonary embolus and cardiac tamponade. A. Dobutamine of infection, such as localized redness, swelling, drainage, fever. Rationale: Tachycardia is more likely than bradycardia in a client who has anemia due to blood loss. include which of the following strategies? because of the decreased ability of the body to carry oxygen to vital tissues and organs. D. Increased clotting factors. The basic three types of pacemakers are the single chamber pacemaker, the dual chamber pacemaker and the biventricular pacemaker. This is a Premium document. Priority Care - ATI templates and testing material. The North American Nursing Diagnosis Association (NANDA) defines altered and ineffective tissue perfusion as "a decrease in oxygen resulting in a failure to nourish tissues at the capillary level." B. Corticosteroids Ventricular arrhythmias occur when the AV junction and the sinoatrial node fail to send their electrical impulses. dopamine IV to improve ventricular function. septic shock. Hemodynamic status is assessed with several parameters -Central venous pressure (CVP) -Pulmonary artery pressure (PAP) -Pulmonary artery wedge pressure (PAWP) -Cardiac Output (CO) -Intra-arterial pressure Mixed venous oxygen saturation (SvO2) indicates the balance between oxygen supply and demand. C. Oliguria Initiate large-bore IV access. rigidity. D. Bradypnea Decreased urine output Hemostasis can be categorized as cerebral, cardiac and peripheral hemostasis and it occurs as the result of vascular constriction and spasm, the clotting of blood and the formation of a platelet plug, all of which impede the free flow of blood throughout the body. Vitamin K prolongs bleeding time. Assess for a history of blood-transfusion reactions. Rationale: ANS: 3PVR is a major contributor to pulmonary hypertension, and a decrease would indicate between hypovolemic shock and cardiac tamponade. Rationale: This CVP is within the expected reference range. This includes neurogenic, septic, and anaphylactic shock Stages of Shock 1. Cardiac output is nonexistent and death is highly likely without immediate treatment. state of inadequate tissue perfusion that impairs cellular function and, Types of Shock (identified by its underlying cause), failure of the heart to pump effectively due to a cardiac, a decrease in intravascular volume of at least 15%-30%, impairment of the heart to pump effectively as a result of, widespread vasodilation and increased capillary, permeability. RegisteredNursing.org Staff Writers | Updated/Verified: Nov 26, 2022. Rationale: While some of the findings indicate cardiac tamponade, the urinary output and CVP distinguish Keep the head of the bed at or below a 30 angle (or flat), unless contraindicated, to relieve pressure on the sacrum, buttocks, and heels. The purpose, the procedure and the management of care for the client before, during and after hemodialysis and peritoneal dialysis were previously fully discussed and described in the section entitled "Performing and Managing the Care of the Client Receiving Dialysis". An idioventricular rhythm is characterized with a ventricular rate of 20 to 40 beats per minute, a regular rhythm, the absence of a P wave, a PR interval that cannot be measured, a deflection of the T wave, and a wide QRS complex that is greater than 0.12 seconds. be a significant source of fluid loss. following is the priority intervention? A nurse on a critical care unit is caring for a client who has shallow and rapid respirations, paradoxical pulse, CVP 4 10 L/min, SVR 4802 dynes/sec/cm5, and WBC 28,000. A nurse is assessing a client who is postoperative and has anemia due to excess blood loss during surgery. B. Purpura symptoms are not indicative of this outcome. All other rhythm strips are abnormal and some of these abnormal rhythms are relatively harmless and often immediately correctable and others can be life threatening when they are not treated promptly and effectively. All trademarks are the property of their respective trademark holders. fluid volume deficit. Consequently, this is the client at greatest risk for fluid volume deficit. Decreased heart rate B. BUN and serum creatinine levels begin to decrease. B. The normal parameters for hemodynamic monitoring values, as shown below. Which classification of medications is likely to stabilize This telemetry technician will immediately run and print out the rhythm strip and notify the nurse of this occurrence. For example, narrowing of the vessels as the result of atherosclerosis and plaque buildup will impede the flow of blood in the body. C. Immediate sodium and fluid retention. degrees, Obtain informed consent Reposition the client in bed at least every 2 hr and every 1 hr in a chair. Do not round off your answer. Rationale: Increased urinary output is associated with the diuresis phase of ARF. A nurse is caring for a client who has hypovolemic shock. increase in platelet consumption involved in the impaired anticoagulant pathways. Infection The client who has congestive heart failure and is on diuretic therapy. Physically, she has no shortness of breath or A. Positive blood culture and elevated oral temperature. Promote excellence in nursing by enabling future and current nurses with the education and employment resources they need to succeed. Which of the following findings A nurse is teaching a client, who has acute renal failure (ARF), about the oliguric phase. This is 2 sphincters: UES and LES also referred to as gasteroesophageal sphincter. STUDENT NAME _____________________________________ anticoagulant pathways are impaired. Bleeding, The diverticulum pouch is removed and the Rationale: The nurse should understand DIC is not controlled with lifelong heparin usage, but Heparin is Most clients affected with Wenckebach or Type I Mobitz heart block are asymptomatic but others may experience syncope, dizziness, fainting and feeling somewhat light headed. Rationale: This is not the correct analysis of the ABGs. The interpretation of these rhythm strips is done according to the details provided above for many cardiac arrhythmias in the previous section entitled "Identifying Cardiac Rhythm Strip Abnormalities", such as the rate, the P wave, the PR interval and the QRS complexes. 2 sphincters: UES and LES also referred to as gasteroesophageal sphincter. A second degree atrioventricular block Type I that has four P waves and three QRS complexes is referred to as a 4:3 Mobitz Type I block and a second degree atrioventricular block Type I that has three P waves and two QRS complexes is referred to as a 3:2 Mobitz Type I block. : an American History (Eric Foner), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward). Agonal rhythms can be caused by a myocardial infarction, trauma and predictable changes at the end of life and it is signaled with the lack of a palpable pulse, the lack of a measurable blood pressure and the complete loss of consciousness. treated with the diuretics. the infusion pump is running at 23 ml/hr, and the client weighs 79 kg. Rationale: A wide QRS complex indicates a dysrhythmia that is an adverse effect, not a therapeutic effect. Assess VS C. ensures that the patient is supine with the head of the bed flat for all readings. D. rechecks the location of the phlebostatic axis when changing the patients position. JGalvan ATI Basic Concept Stages and Phases of Labor. If the patient is hemorrhaging, efforts are made to stop the bleeding or if the cause is diarrhea or vomiting, medications to treat diarrhea and vomiting are administered. The nurse suspects that a client with a central venous catheter in the left subclavian vein is experiencing an air Some of the complications associated with sinus tachycardia include a decrease in terms of the client's cardiac output and a myocardial infarction. A. B. C. The client who has end-stage renal failure and is scheduled for dialysis today. Compensatory (non- progressive)- Measures to increase cardiac output to restore tissue perfusion and oxygenation3. Second degree AV block type II, also known as Mobitz type II, occurs when the AV node impulses are intermittently blocked and do not reach the heart's ventricles. Which of the following is a manifestation of hypovolemia? Rationale: While some of the findings might indicate atelectasis, the combination of the clients signs and Rationale: Petechiae characterize the progressive stage of shock. A nurse in the emergency department is caring for a client who has anaphylaxis following a bee sting. support this conclusion? The treatment of atrial fibrillation includes the control of the cardiac rate with medications such as beta blockers, calcium channel blockers, or digoxin, intravenous verapamil when rapid cardiac rate reduction is necessary, cardioversion, supplemental oxygen, and antithrombolytic medications to prevent clot formation and pulmonary emboli. She got her bachelors of science in nursing with Excelsior College, a part of the New York State University and immediately upon graduation she began graduate school at Adelphi University on Long Island, New York. Regurgitation anticipate administering to this client? The risk factors associated with supraventricular tachycardia include atherosclerosis, hypokalemia, hypoxia, stress, and stimulants; and some of the signs and symptoms include polyuria, palpitations, syncope, dizziness, chest tightness, diaphoresis, fatigue, and shortness of breath. The risks and complications of atrial fibrillation include atrial clot formation, a pulmonary embolus, a cerebrovascular accident, and a significant and dramatic drop in cardiac output. Of all the cardiac rhythms, only the normal sinus rhythm is considered normal. The goal of using hemodynamics is to evaluate cardiac and circulatory function as well as evaluate response to interventions. B. 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