A 45-year-old male is visiting the wellness clinic and has been newly diagnosed as a stage I hypertensive patient. His blood pressure assessment over the past 6 months has consistently been 145/92 mm Hg. The patient asks, “What is blood pressure?” What is the best response by the nurse?
A) “A measurement that takes into consideration the amount of blood your heart is pumping and the size of the vessel diameter the heart must pump against.”
What is the best position for the nurse to place the patient in to obtain a right atrial pressure measurement?
A) Supine, either flat or with the head of the bed no more than 60 degrees
What is the best action by the nurse to accurately record a thermodilution cardiac output (CO)?
C) Position the patient supine, obtain three values within 10% of each other, and calculate the average cardiac output.
What is the best understanding of mixed venous oxygen saturation by the nurse?
A) An overall picture of oxygen delivery and oxygen consumption
What is the best action by the nurse to level and zero a hemodynamic monitoring system transducer?
D) Position the air-fluid interface of the zeroing transducer at the phlebostatic axis; fourth intercostal space, midaxillary line.
When checking a patient’s pulmonary artery occlusion pressure, the nurse inflates the balloon as ordered, not inflating the balloon for more than 8 to 10 seconds. What is the best understanding of this action by the nurse?
D) Prolonged inflation can obstruct blood flow, resulting in ischemia.
The nurse begins to review orders recently entered by the cardiologist. Medication orders include dobutamine (Dobutrex) 400 mg in 250 mL 5% dextrose in water titrated to keep cardiac index > 2 L/min/m2. What is the best understanding of cardiac index by the nurse?
B) The measurement specific to the patient’s size or body area
The nurse is caring for a patient being monitored with a central venous catheter. In preparing to record a right atrial pressure reading, what is most important for the nurse to understand in recording an accurate value?
A) Record the pressure at the end of expiration.
The nurse is preparing a patient for assessment of cardiac output using an esophageal monitor. What is the best understanding of this procedure by the nurse?
D) The procedure involves a thin probe inserted into the esophagus.
The physician orders cardiac output monitoring for a mechanically ventilated, hemodynamically unstable patient. The nurse prepares to set up a Vigileo pulse contour monitoring system. What is the best understanding of this technology by the nurse?
C) The device provides better predictors of fluid responsiveness than RAP.
The physician orders continuous cardiac output (CCO) monitoring for a patient admitted in cardiogenic shock. Which statement(s) best describes advantages associated with the continuous monitoring of cardiac output? (Select all that apply.)
E) No extra fluid is administered to the patient.
C) Data are continuously available for trending.
D) There is no need to change the computation constant.
The nurse needs to obtain a cardiac output measurement from a patient who has just had a pulmonary artery catheter inserted. What are important interventions for ensuring accurate pressure and cardiac output measurements? (Select all that apply.)
D) Ensure rapid injection of fluid through the injectate port.B) Zero reference the transducer system at the phlebostatic axis.