A client in the ICU has a pulmonary artery catheter in place.
Which hemodynamic parameters are directly measured using this catheter?
Mean arterial pressure (MAP), cardiac output (CO), and pulmonary artery pressure (PAP).
Pulmonary artery pressure (PAP), pulmonary artery wedge pressure (PAWP), and cardiac output (CO).
Mean arterial pressure (MAP), central venous pressure (CVP), and systemic vascular resistance (SVR).
Cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR).
The Correct Answer is B
Monitoring critical illness requires understanding hemodynamic monitoring through invasive catheters. Knowledge of cardiovascular physiology and the specific capabilities of the Swan-Ganz catheter is necessary to distinguish between parameters that are directly measured versus those calculated via mathematical hemodynamic formulas.
Choice A rationale
Pulmonary artery catheters do not measure mean arterial pressure, which requires a peripheral arterial line. PAP and CO are measured, but the inclusion of MAP makes this choice incorrect as it assesses systemic rather than pulmonary hemodynamics.
Choice B rationale
This catheter sits in the pulmonary artery, allowing direct measurement of systolic, diastolic, and mean PAP. Inflation of the balloon allows measurement of PAWP, while thermistor technology enables the direct calculation of cardiac output via thermodilation.
Choice C rationale
Central venous pressure is measured via the proximal port of the catheter, but MAP and SVR are not direct measurements. SVR is a calculated value derived from MAP, CVP, and CO using a mathematical formula.
Choice D rationale
While cardiac output is measured directly, stroke volume and systemic vascular resistance are calculated parameters. Stroke volume is determined by dividing cardiac output by heart rate, while SVR utilizes the pressure gradient across the systemic circuit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This scenario requires applying knowledge of burn pathophysiology, specifically the emergent phase and fluid resuscitation. Understanding clinical indicators of hypovolemia, such as heart rate and urine output, is essential to recognize inadequate perfusion and potential hypovolemic shock.
Choice A rationale
Normal adult respirations range from 12 to 20 breaths per minute. A pulse of 60 bpm is at the low end of the normal range of 60 to 100 bpm, which does not suggest hypovolemic shock.
Choice B rationale
A temperature of 98.4 F is within the normal range of 97 F to 99 F. While a pulse of 106 bpm is slightly tachycardic, it is not a definitive indicator of critical fluid deficit.
Choice C rationale
A blood pressure of 92/60 mm Hg is borderline low, but a pulse of 100 bpm is at the upper limit of normal. These findings are less concerning than those indicating direct organ hypoperfusion.
Choice D rationale
Tachycardia of 130 bpm and urine output below 30 mL/hr signify inadequate fluid resuscitation. Normal urine output is at least 0.5 mL/kg/hr, or 30 mL/hr, indicating decreased renal perfusion and significant hypovolemia in burn patients.
Correct Answer is ["B","C","F"]
Explanation
This question tests knowledge of silver sulfadiazine, a topical antimicrobial used in burn care. Understanding its mechanism, application techniques, and properties is necessary to evaluate the accuracy of the client's statements regarding its use and therapeutic effects.
Choice A rationale
Silver sulfadiazine is typically applied in a thin layer and may be left open to air or covered with a light dressing. Instructing that a dressing should never be used is incorrect and clinically inaccurate.
Choice B rationale
Silver sulfadiazine is a broad-spectrum antimicrobial agent. Its primary purpose is to prevent and treat sepsis in second-degree and third-degree burns by inhibiting the growth of microorganisms that could lead to systemic or local infection.
Choice C rationale
The medication should be applied to burned areas requiring antimicrobial protection. Applying the cream specifically to open areas prevents unnecessary skin irritation on intact skin while providing targeted treatment to vulnerable, damaged tissues prone to bacterial colonization.
Choice D rationale
Old ointment should be removed before reapplying a new layer, but a tongue blade is used for application, not removal. Removal is generally done by gentle cleansing with water or saline to avoid trauma.
Choice E rationale
Silver sulfadiazine is a white, water-soluble cream. It is not dark in color and is easily removed with water. The statement that it cannot be removed with water indicates a misunderstanding of the product's properties.
Choice F rationale
Silver sulfadiazine has effective antimicrobial properties against a wide range of gram-positive and gram-negative bacteria, as well as yeast such as Candida albicans. This broad coverage makes it a standard choice for burn wound management..
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