Following insertion of a CVP (central venous pressure) catheter into the right subclavian vein, which assessment finding should be of most concern to you?

CVP reading of 8

SVR (systemic vascular resistance) 1000 dynes/sec/cm2

Inability to auscultate breath sounds on the right side

Urine output of 30 mL/hour for the last hour

Answer and Explanation

The Correct Answer is C

A. A CVP of 8 mmHg is within the upper normal range (2–8 mmHg) and is not immediately concerning.
B. SVR of 1000 dynes/sec/cm² is within a typical range for adults and does not indicate acute complications.
C. Inability to auscultate breath sounds on the side of catheter insertion suggests possible pneumothorax, a serious complication of subclavian CVP insertion that requires immediate attention.
D. Urine output of 30 mL/hour is acceptable and does not indicate acute renal compromise.

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Correct Answer is D

Explanation

A. The synchronizer switch should be on, not in manual mode, to ensure the shock is delivered during the R wave and avoid inducing ventricular fibrillation. Manual mode is used for defibrillation, not synchronized cardioversion.
B. Turning the synchronizer off is inappropriate for cardioversion, as the shock must be synchronized with the QRS complex.
C. Although the client should remain still, cardioversion is painful and generally requires sedation, so this alone is insufficient.
D. Clients undergoing elective synchronized cardioversion while alert require sedation to reduce pain and anxiety during the procedure. Administering a sedative is a priority nursing action before delivering the shock to ensure client safety and comfort.

A. furosemide 20 mg IVP. B. dopamine infusion at 2 mcg/kg/min. C. a fluid bolus. D. amiodarone 150 mg IVP.

Correct Answer is A

Explanation

A. The rising CVP, low urine output, and pulmonary crackles indicate fluid overload and left-sided heart failure. Furosemide, a loop diuretic, promotes diuresis to reduce preload and relieve pulmonary congestion.
B. Dopamine may improve renal perfusion but does not directly treat fluid overload and pulmonary edema.
C. A fluid bolus would worsen volume overload and pulmonary congestion.
D. Amiodarone is used to treat arrhythmias; there is no indication of arrhythmia in this scenario.

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Following insertion of a CVP (central venous pressure) catheter into the right subclavian vein, which assessment finding should be of most concern to you?

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Naxlex Comprehensive Predictor Exams

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Explanation

Correct Answer is A

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