After the nurse obtains a blood sample from a client's right radial arterial client reports a sudden onset of pain at the arterial line insertion site. The nurse recognizes which physiological effect may be inducing the sudden pain?

Elevation in blood pressure.

Vasospasm at insertion site.

Clot in the arterial catheter.

Air lock in the transducer.

Answer and Explanation

The Correct Answer is B

A) Elevation in blood pressure:

While elevation in blood pressure could potentially cause discomfort at the arterial line insertion site, it is not the most likely physiological effect to induce sudden pain in this scenario. Blood pressure elevation would typically cause generalized symptoms rather than localized pain at the insertion site.

B) Vasospasm at insertion site:

Correct. Vasospasm refers to the sudden constriction of blood vessels, leading to reduced blood flow. It can occur in response to arterial puncture or manipulation during arterial line insertion, resulting in sudden pain at the insertion site.

C) Clot in the arterial catheter:

A clot in the arterial catheter could potentially cause obstruction and affect blood flow, but it is less likely to induce sudden pain at the insertion site unless there is associated ischemia or tissue damage.

D) Air lock in the transducer:

An air lock in the transducer could disrupt pressure monitoring but is not typically associated with sudden pain at the insertion site. It may lead to inaccurate pressure readings rather than localized pain.

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Correct Answer is C

Explanation

A) An increase in afterload results in decreased systolic pressure, which creates a decreased cardiac output:

This statement is not consistent with the Frank-Starling law. Afterload refers to the resistance against which the heart must pump blood during systole. An increase in afterload typically results in increased systolic pressure, not decreased, as the heart works harder to overcome the increased resistance. However, increased afterload can lead to decreased cardiac output due to the increased work of the heart.

B) A decrease in afterload causes the cardiac muscles to hypertrophy, resulting in increased diastolic volume:

This statement is not consistent with the Frank-Starling law. Afterload refers to the pressure or resistance against which the heart must pump blood during systole. A decrease in afterload typically reduces the workload on the heart, which may lead to reverse remodeling and a reduction in cardiac hypertrophy. Increased diastolic volume may occur due to reduced afterload, but it's not the direct result of hypertrophy.

C) An increase in preload results in greater shortening of myocardial fibers, thereby increasing contractility:

Correct. According to the Frank-Starling law, an increase in preload (end-diastolic volume or stretch of myocardial fibers) leads to greater overlap of actin and myosin filaments within myocardial fibers during systole. This increased overlap results in stronger myocardial contraction (increased contractility), leading to an increased stroke volume and cardiac output.

D) A decrease in preload results in increasing diastolic muscle fiber length, which impedes contractility:

This statement is not consistent with the Frank-Starling law. Preload refers to the degree of stretch of the myocardial fibers at the end of diastole. A decrease in preload would lead to decreased stretch of the myocardial fibers, not increasing diastolic muscle fiber length. Decreased preload typically results in decreased contractility rather than impediment to contractility due to reduced myocardial stretch.

A. Deficiency of factors VIII or IX. B. Diminished amount of vitamin K. C. Decreased amount of platelets. D. Missing factors V and VII.

Correct Answer is A

Explanation

A) Deficiency of factors VIII or IX.

Hemophilia is a genetic disorder characterized by deficient or defective clotting factors, specifically factors VIII (hemophilia A) or IX (hemophilia B). These clotting factors are essential for the formation of stable blood clots. Therefore, if hemophilia is present, the deficiency of factors VIII or IX can lead to impaired clot formation and prolonged bleeding.

B) Diminished amount of vitamin K:

Vitamin K deficiency can lead to impaired blood clotting due to inadequate synthesis of clotting factors in the liver. However, hemophilia is specifically associated with deficiencies in factors VIII or IX, not vitamin K.

C) Decreased amount of platelets:

Platelets play a crucial role in primary hemostasis and initial platelet plug formation at the site of vascular injury. While decreased platelet count or dysfunction can lead to bleeding disorders such as thrombocytopenia or platelet function disorders, hemophilia specifically involves deficiencies in clotting factors, not platelets.

D) Missing factors V and VII:

Factor V and VII are other clotting factors involved in the coagulation cascade, but they are not deficient in hemophilia. Hemophilia is specifically characterized by deficiencies in factors VIII (hemophilia A) or IX (hemophilia B).

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After the nurse obtains a blood sample from a client's right radial arterial client reports a sudden onset of pain at the arterial line insertion site. The nurse recognizes which physiological effect may be inducing the sudden pain?

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