The nurse is caring for a patient admitted with cardiogenic shock. Hemodynamic readings obtained with a pulmonary artery catheter include a pulmonary artery occlusion pressure (PAOP) of 18 mm Hg and a cardiac index (CI) of 1.0 L/min/m2
What is the priority pharmacological intervention? a. Dobutamine (Dobutrex)
b. Furosemide (Lasix)
c. Phenylephrine (Neo-Synephrine)
d. Sodium nitroprusside (Nipride)
A
Positive inotropic agents (e.g., dobutamine) are given to increase the contractile force of the heart. As contractility increases, cardiac output and index increase and improve tissue perfusion. Administration of furosemide will assist only in managing fluid volume overload. Phenylephrine administration enhances vasoconstriction, which may increase afterload and further reduce cardiac output. Sodium nitroprusside is given to reduce afterload. There is no evidence to support a need for afterload reduction in this scenario.
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An adolescent visits the school nurse to ask why she is getting frequent urinary tract infections. Which questions should the nurse ask the client during this visit?
Select all that apply. 1. "Have you been eating foods that have high acidity?" 2. "Do you drink a lot of milk?" 3. "Do you take bubble baths frequently?" 4. "What direction do you wipe after a bowel movement?" 5. "Do you have a family history of urinary tract infections?"
Stakeholders who might be represented within the process of performance appraisal of a CCU nurse include (select all that apply):
a. patients/patient families. b. the CCU social worker. c. the chief financial officer. d. organizational board members. e. nurses in the ED.
Which of the following items creates the greatest risk for a patient with leukopenia?
a. A get-well card from a family member. b. A fresh apple brought in by a friend. c. A paperback book purchased at the hospital gift shop. d. A can of soda from a vending machine.
Which is the appropriate initial intervention for the nursing diagnostic statement Impaired skin integrity related to poor wound healing?
a. Reinforce the wound dressing as needed with 4 x 4 gauze. b. Perform the ordered dressing change twice daily. c. Document wound characteristics. d. Assess wound appearance each shift.