A nurse recognizes that alterations in cardiac output are caused by changes in heart rate, preload, afterload, and contractility. Which interventions are correctly matched to treat the cause of low cardiac output? Select all that apply.
a) Low afterload: administer vasopressor.
b) Low afterload: administer vasodilator.
c) Low right atrial (R

Low afterload: administer vasopressor.

Low afterload: administer vasodilator.

Low right atrial (RA) pressure: administer diuretics.

Low preload: administer fluid bolus.

High preload: administer diuretic or vasodilator.

Answer and Explanation

Correct Answer : D

Choice A reason: Administering a vasopressor is not appropriate for low afterload. Vasopressors are used to increase blood pressure by causing vasoconstriction, which increases afterload. However, the administration of a vasopressor for low afterload is contradictory because the goal for low afterload would be to reduce the strain on the heart, not to increase it.

Choice B reason: Administering a vasodilator for low afterload is not correct. Vasodilators decrease afterload by causing the blood vessels to widen, reducing the resistance the heart has to pump against. Administering a vasodilator to treat low afterload is inappropriate because it would further lower afterload, potentially leading to inadequate perfusion and worsening cardiac output.

Choice C reason: Administering diuretics for low right atrial (RA) pressure is inappropriate. Diuretics help to remove excess fluid from the body, reducing blood volume and venous pressure. However, if a patient has low right atrial pressure, reducing blood volume further with diuretics could exacerbate the issue, leading to decreased cardiac output and poor perfusion.

Choice D reason: Administering a fluid bolus is the correct intervention for low preload. Preload refers to the volume of blood in the ventricles at the end of diastole. If preload is low, administering fluids increases blood volume, which enhances ventricular filling and improves cardiac output. This intervention helps to stabilize hemodynamics and improve overall perfusion.

Choice E reason: Administering a diuretic or vasodilator is the appropriate intervention for high preload. High preload indicates an excess of blood volume returning to the heart, which can strain the cardiac muscle and reduce efficiency. Diuretics help remove excess fluid, while vasodilators decrease venous return and reduce the volume of blood the heart has to handle, thus optimizing cardiac function and output.

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Correct Answer is ["A","C","E"]

Explanation

Choice A reason: Initiating a bowel regimen program is essential to avoid constipation, which can be a trigger for autonomic dysreflexia in patients with spinal cord injuries. Ensuring regular bowel movements helps prevent the discomfort and complications that can lead to this potentially life-threatening condition.

Choice B reason: Applying tight-fitting clothing is contraindicated as it can cause skin irritation, pressure sores, and other discomforts that could trigger autonomic dysreflexia. Loose and comfortable clothing is recommended to prevent these issues.

Choice C reason: Completing frequent skin checks is crucial for detecting and preventing pressure ulcers, skin infections, and other skin conditions that can act as noxious stimuli, triggering autonomic dysreflexia. Regular skin assessments help ensure early identification and management of potential issues.

Choice D reason: Restricting all patient visitors is not necessary for preventing autonomic dysreflexia. While it is important to manage the patient's environment and stress levels, complete visitor restriction is not a standard intervention for this condition.

Choice E reason: Inserting an indwelling Foley catheter is beneficial for managing bladder function and preventing urinary retention, a common trigger for autonomic dysreflexia. Continuous bladder drainage helps prevent distention and the subsequent risk of triggering this condition.

A. Reposition the patient frequently and promote deep breathing. B. Infuse the dialysate slowly. C. Use strict aseptic technique in the dialysis procedures. D. Have the patient empty the bowel before the inflow phase.

Correct Answer is C

Explanation

Choice A reason: Repositioning the patient frequently and promoting deep breathing are important interventions for various conditions, particularly for preventing atelectasis and respiratory complications. However, they are not directly related to preventing the most common serious complication of peritoneal dialysis, which is peritonitis.

Choice B reason: Infusing the dialysate slowly can help manage discomfort and ensure proper fluid exchange during peritoneal dialysis. However, it does not address the most serious complication, which is infection.

Choice C reason: Using strict aseptic technique in dialysis procedures is crucial in preventing peritonitis, the most serious and common complication of peritoneal dialysis. Peritonitis is an infection of the peritoneal cavity and can lead to severe complications if not prevented. Adhering to aseptic techniques during catheter insertion, connection, disconnection, and any other procedure involving the dialysis system is essential to reduce the risk of infection.

Choice D reason: Having the patient empty the bowel before the inflow phase can help ensure adequate space in the peritoneal cavity for the dialysate and prevent discomfort. However, this action does not directly prevent the serious complication of peritonitis.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a mechanically ventilated spinal cord injury patient in the ICU. To avoid the complication of autonomic dysreflexia, the nurse plans to implement the following orders: Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

To prevent the most common serious complication of peritoneal dialysis, it is important for the nurse to:

Correct Answer is C

Explanation

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