The nurse is caring for a patient with sepsis. On completing the hemodynamic assessment, the nurse notes that the patient's afterload, measured by the systemic vascular resistance, is 400 dynes/sec/cm-5
These findings are most likely a result of which of the following? 1. decreased circulating volume
2. decreased ventricular contractility
3. marked vasodilation
4. reaction to antibiotics used to treat sepsis
3
Rationale: Sepsis, through its release of inflammatory mediators, causes vasodilation, resulting in the markedly low systemic vascular resistance. In sepsis, the amount of volume available does not change; the marked vasodilation that occurs reduces the amount available to maintain cardiac output. Ventricular contractility may be reduced following the release of myocardial depressant factor as a result of sepsis. However, the primary cause of the decreased systemic vascular resistance is the systemic vasodilation that occurs. Although anaphylaxis, which may cause systemic vasodilation, is always a concern, this is not the primary reason for the decreased systemic vascular resistance.
You might also like to view...
The patient has been exposed to significant levels of carbon monoxide. What component of blood does the nurse most need to examine for adverse effects?
A) Plasma volume B) Neutrophil count C) Hemoglobin saturation D) Arterial plasma pH
The nurse is transferring a patient who is in the progressive stage of shock into ICU from the medical unit. The medical nurse is aware that shock affects many organ systems and that nursing management of the patient will focus on what intervention?
A) Reviewing the cause of shock and prioritizing the patient's psychosocial needs B) Assessing and understanding shock and the significant changes in assessment data to guide the plan of care C) Giving the prescribed treatment, but shifting focus to providing family time as the patient is unlikely to survive D) Promoting the patient's coping skills in an effort to better deal with the physiologic changes accompanying shock
A primigravida is admitted to the birth setting in early labor. She is 3 cm dilated, -2 station, with intact membranes and FHR of 150 beats/min. Her membranes rupture spontaneously, and the FHR drops to 90 beats/min with variable decelerations
The initial response from the nurse would be to: 1. Perform a vaginal exam. 2. Notify the physician. 3. Place the patient in a left lateral position. 4. Administer oxygen at 2 L per nasal cannula.
When a case is eliminated completely because of missing data, the strategy is referred to as:
A) Listwise deletion B) Deletion of variable C) Mean substitution D) Pairwise deletion