A nurse is teaching a client, who has acute renal failure (ARF), about the oliguric phase. 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. loss. Some of the signs and symptoms of sinus tachycardia include: Some of the treatments for sinus tachycardia include the treatment of an underlying disorder or a problematic medication and no treatments when the client is asymptomatic. A. Systolic blood pressure increases. Rho D immune globulin - ATI templates and testing material. The nurse should recognize that the client is exhibiting symptoms of which condition? This increasing prolongation leads to the progressive lengthening of the PR interval until is leads to a non conducted P wave and the absence of a QRS complex. Rationale: Decreased urine output is a sign of shock, but it is not the earliest indicator. double-check the dosage that the client is receiving. Immediate CPR and ACLS protocols, cardioversion, the placement of an internal pacemaker, amiodarone, lidocaine and antiarrhythmic medications may be used for the treatment of ventricular fibrillation according to the client's condition and their choices. A nurse in the emergency department is caring for a client who has anaphylaxis following a bee sting. Chronic cough This is a Premium document. Treatments for this heart block can include intravenous atropine, supplemental oxygen, and, in some cases, a temporary or permanent pacemaker, as indicated. Which classification of medications is likely to stabilize Decreased urine output Rationale: Oliguria is present in hypovolemic shock as a result of decreased blood flow to the kidneys. Low RA pressure The P wave is present before each QRS complex, the PR interval is more than 0.20 seconds. As more fully detailed and discussed previously in the section entitled "Identifying the Client with Increased Risk for Insufficient Vascular Perfusion", some of the risk factors associated with impaired tissue perfusion are hypovolemia, hypoxia, hypotension and impaired circulatory oxygen transport, among other causes. The risk factors associated with ventricular tachycardia include severe cardiac disease, myocardial ischemia, a myocardial infarction, digitalis toxicity, some electrolyte imbalances, heart failure and some medications. This is Home and Safety - ATI templates and testing material. C. Bradycardia Third-degree AV block is treated with a pacemaker, medications to control atrial fibrillation and the client's blood pressure, as well as the treatment of any identifiable causes including life style choices and other modifiable risk factors. include which of the following strategies? This abnormal sinus rhythm can occur secondary to hypothyroidism, some medications like a beta blocker or digitalis, increased intracranial pressure, hypoglycemia, hypothermia, preexisting heart disease and an inferior wall myocardial infarction which involves the right coronary artery. . Rationale: This CVP is within the expected reference range. Hemodynamic studies reveal the following: BP 102/72 mm Hg; pulse 105; pulmonary arterial pressure C. Edema and weight gain, with increasing shortness of breath. The complications can include ventricular fibrillation which can lead to cardiac arrest. Clients affected with bundle branch block may be symptomatic and asymptomatic. this complication is developing? Rationale: Decreaseing the amount of stretch in cardiac muscle just before contraction decreases the Ineffective tissue perfusion can occur and adversely affect the brain, the renal system, the heart and the heart muscle, the gastrointestinal tract and the peripheral vascular system. JGalvan ATI Basic Concept Stages and Phases of Labor. dopamine IV to improve ventricular function. B. Peritonitis. The treatments for an idioventricular rhythm include a cardiac pacemaker, the administration of atropine, the administration of dopamine when the client is adversely affected with hypotension, and cardiopulmonary resuscitation when this cardiac arrhythmia leads to cardiac stand still and asystole. B. reducing preload deficit? 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. Platelets Rationale: The clients blood pressure will decrease due to decreased blood volume. Rationale: Tachycardia is more likely than bradycardia in a client who has anemia due to blood loss. Rationale: The nurse should monitor for hypotension; however, this is not the priority intervention when Rationale: Hypotension is a sign of hypovolemic shock. Home and Safety - ATI templates and testing material. 3 mm Hg The signs and symptoms related to the hypoperfusion of the peripheral vascular system include intermittent claudication, weak or absent peripheral pulses, aches, pain, coolness and numbness of the extremities, clammy and mottled skin, the lack of the same blood pressure on both limbs, edema and slow capillary refill times. systolic blood pressure. For example, venous stasis or hemostasis is a commonly occurring complication of immobility and during the post-operative period of time. There are In addition to the management of cardiac arrhythmias, as previously discussed in the section above that was entitled Identifying Cardiac Rhythm Strip Abnormalities" including the signs, symptoms, ECG rhythm strips, medical and nursing interventions and emergency care using CPR and ACLS protocols, nurses also monitor and maintain cardiac pacemakers. D. Elevate the head of the patients bed to 45 degrees. formation and platelet counts. This is, Tachypnea is more likely than respiratory depression in a client who has anemia due to blood. Decreased heart rate Esophageal disorders can affect any part of the esophagus. RegisteredNursing.org does not guarantee the accuracy or results of any of this information. The signs and symptoms of decreased cardiac output include the abnormal presence of S3 and S4 heart sounds, hypotension, bradycardia, tachycardia, weak and diminished peripheral pulses, hypoxia, cardiac dysrhythmias, palpitations, decreased central venous pressure, decreased pulmonary artery pressure, dyspnea, fatigue, oliguria and possible anuria, decreased organ and tissue perfusion, and adventitious breath sounds like crackles, and orthopnea. 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 signs and symptoms of this cardiac arrhythmia can include syncope, dizziness, fainting, chest pain and a loss of consciousness. A septic patient with hypotension is being treated with dopamine hydrochloride. is a right bundle branch block in combination with a left anterior fascicular block or a left posterior fascicular block. Reoccurence of bladder neck obstruction---> Urethral trauma, urinary retention, bleeding, and infection *Monitor the client and intervene for bleeding Compensatory (non- progressive)- Measures to increase cardiac output to restore tissue perfusion and oxygenation3. Rationale: The nurse should evaluate for local edema; however, this is not the priority intervention when Most episodes of transient first degree heart block are benign and asymptomatic, but at times, it can lead to atrial fibrillation and other cardiac irregularities of varying severity according to the length of the PR interval prolongation. anticipate administering to this client? The nurse should expect which of the following (CVP) measurements? 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. elevated platelet count. Sinus tachycardia is a sinus rhythm that is like the normal sinus rhythm with the exception of the number of beats per minute. Rationale: The PAWP is a mean pressure that is expected to range between 4 and 12 mm Hg. rigidity. Some of contraindications for the use of an arterial line include severe burns near the desired site, impaired circulation to the site, pulselessness, Buergers disease, and Raynaud syndrome; and arterial lines are cautiously implanted and used when the client is affected with atherosclerosis, a clotting disorder, impaired circulation, scar tissue near the desired site, and the presence of a synthetic graft. 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. The client loses consciousness and there is an absent pulse during ventricular fibrillation; emergency measures include CPR, ACLS protocols including defibrillation, and other life saving measures are indicated for the client with this highly serious life threatening cardiac arrythmia. diaphoresis, and fever raises the metabolic rate, further putting the client at increased risk for 18- or The cardiac rate is typically normal, the cardiac rhythm is irregular because of this compensatory pause, the p wave occurs prior to each QRS complex and it is typically upright but not always with its normal shape, the PR interval is from 0.12 to0.20 seconds, the QRS complexes look alike, and the length of the QRS complexes ranges from 0.06 to 0.12 seconds. (PAP) 30/16; PAWP 13; CVP 16; Cardiac Output 4; Cardiac index 2. C. increasing contractility Cross), Give Me Liberty! Atrial arrhythmias occur when the heart's natural pacemaker, the sinoatrial node does not generate the necessary impulses that are required for the normalfunctioning of the heart. 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. Rationale: ANS: 3PVR is a major contributor to pulmonary hypertension, and a decrease would indicate (Place the phases of acute kidney injury in the order that they occur. Progressive- Compensatory mechanisms begin to fail 4. D. increasing preload. Which of the following changes indicates to the nurse that the 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. mottled, cool and pale skin, dizziness, hypotension, weakness, and changes in terms of the client's mental status and level of consciousness. anticoagulant pathways are impaired. A. This telemetry technician will immediately run and print out the rhythm strip and notify the nurse of this occurrence. medications given to a patient to reduce left ventricular afterload? C. dopamine to increase the blood pressure. Rationale: The nurse should observe for periorbital edema; however, this is not the priority intervention Which of the following is an expected finding? Hemodynamic shock - ATI templates and testing material. The treatment of this serious and highly life threatening dysrhythmia includes the initiation of CPR and the advanced cardiac life support (ACLS) protocols, if the client has chosen these life saving treatments. Use of nicotine transdermal patch Hemodynamic Shock: Client Positioning; For hypotension, place the client flat with both legs elevated to increase venous return. administered to minimize the formation of microthrombi to improve tissue profusion. A nurse is caring for a client who has hypovolemic shock. Inspect the blood for discoloration, Prior to transfusion, two RNs must identify the correct blood product and client, by looking at the hospital identification number (noted on the blood product) and the, number identified on the client's identification band to make sure the numbers, The nurse completing the blood product verification must be one of the nurses, Prime the blood administration set with 0.9% sodium chloride only. Priority Care - ATI templates and testing material. C. Reinforce teaching regarding gargling with warm saline several times daily. D. Metabolic acidosis A client experiences anaphylactic shock in response to the administration of penicillin. medication is having a therapeutic effect? A. Rationale: A CVP above 6 mm Hg indicates an increased right ventricular preload, typically from DIC is controllable with lifelong heparin usage. 40 Comments Please sign inor registerto post comments. The rate is slow and less than 20 beats per minute, the rhythm is typically regular, the P wave is absent, the PR interval is not measurable, and the QRS interval is abnormally wide and more than 0.12 seconds with an abnormal T wave deflection. What should the nurse prepare to implement first? C. Pulmonary vascular resistance (PVR) Premature atrial contractions occur when the p wave occurs prematurely. Rationale: Increased urinary output is associated with the diuresis phase of ARF. Regrowth of prostate tissue 2. medications should the nurse administer first? Document position changes. thready peripheral pulses and flattened neck veins. The classical features of torsades de pointes are a long QT interval in addition to a downward and upward deflection of the QRS complexes that are seen on the cardiac strip. 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. 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