The nurse is collecting a blood sample for a mixed venous oxygen saturation (SVO2) level from the distal lumen of a pulmonary artery (PA) catheter of a client in cardiogenic shock. Which action should the nurse implement?
Expel the excess air and heparin from the syringe.
Place sample in arterial blood gas syringe.
Obtain a minimum of 1 mL of blood.
Aspirate the blood sample slowly.
The Correct Answer is C
A. Expel the excess air and heparin from the syringe. While removing excess air prevents gas exchange alterations, this is not the priority when obtaining an SVO₂ sample. Excess heparin could dilute the sample, but proper blood volume collection is the first concern.
B. Place sample in arterial blood gas syringe. SVO₂ measures venous oxygen saturation, which is different from arterial blood gases (ABGs). Using an ABG syringe is incorrect because it is heparinized for arterial sampling, and arterial blood does not reflect mixed venous oxygenation.
C. Obtain a minimum of 1 mL of blood. SVO₂ is measured from the distal lumen of a pulmonary artery (PA) catheter to assess oxygen delivery and consumption. At least 1 mL of blood is required for an accurate reading, ensuring sufficient sample volume for laboratory analysis.
D. Aspirate the blood sample slowly. While slow aspiration can help prevent hemolysis, it is not the primary concern when collecting an SVO₂ sample. The priority is obtaining a sufficient volume (≥1 mL) for an accurate measurement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["5"]
Explanation
Calculation:
Calculate the New Nitroglycerin Dose in mcg/hour
Dose (mcg/hour) = Dose (mcg/min) × 60 min/hour
=15 mcg/min × 60 min/hour = 900 mcg/hour
Convert mcg to mg
Dose (mg/hour) = Dose (mcg/hour) / 1000 mcg/mg
=900 mcg/hour / 1000 mcg/mg
= 0.9 mg/hour
Calculate the Concentration of Nitroglycerin in the IV Bag
Concentration (mg/mL) = Total mg of Nitroglycerin / Total mL of Solution
=50 mg / 250 mL
= 0.2 mg/mL
Calculate the Infusion Rate = Infusion Rate (mL/hour)
=0.9 mg/hour / 0.2 mg/mL
= 4.5 mL/hour
Round to the Nearest Whole Number
4.5 mL/hour rounded to 5 mL/hour
Correct Answer is A
Explanation
A. Insert a large bore peripheral IV catheter. The client is showing signs of shock (tachycardia, hypotension, tachypnea) likely due to envenomation and systemic venom effects. Rapid IV access is essential for fluid resuscitation, administration of antivenom, and management of shock. A large bore (18-gauge or larger) IV catheter allows for aggressive fluid therapy to maintain perfusion and prevent circulatory collapse.
B. Raise extremity above the heart. Elevating the limb can increase venom circulation, worsening systemic effects. Instead, the affected extremity should be kept at heart level to slow venom spread while ensuring adequate perfusion.
C. Tighten the cloth around the leg. Further tightening the makeshift tourniquet can lead to vascular compromise, ischemia, and increased local tissue damage. Modern guidelines discourage tourniquets as they do not prevent venom spread effectively and may worsen outcomes. The best approach is to loosen or remove restrictive bindings and keep the limb immobilized at heart level.
D. Apply ice over the bite mark. Cold therapy is contraindicated as it can worsen tissue damage by causing vasoconstriction, trapping venom, and increasing necrosis. Instead, the priority is IV access, fluid resuscitation, and preparing for possible antivenom administration.
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