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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Normal sinus rhythm (NSR) at 84 beats/minute. The goal of cardioversion for atrial fibrillation (AFib) is to restore a normal sinus rhythm (NSR). NSR indicates that the atria and ventricles are depolarizing in a coordinated manner, reducing the risk of thromboembolism, stroke, and hemodynamic instability. A heart rate of 84 beats/minute is within the normal range, confirming the success of the procedure.
B. Regular rhythm with consistent pacemaker capture. Cardioversion is used to restore normal rhythm in AFib, not to manage pacemaker function. A pacemaker is not part of standard AFib cardioversion unless the client has underlying conduction issues requiring pacing.
C. Return of elevated ST segment to the baseline. ST elevation suggests acute myocardial infarction (MI), which is unrelated to atrial fibrillation or cardioversion. Cardioversion does not treat ST elevation or myocardial ischemia, making this an incorrect indicator of success.
D. Increased frequency of QRS complexes. An increase in QRS frequency suggests tachycardia, which would indicate treatment failure rather than success. The goal of cardioversion is to restore a normal, controlled heart rate and rhythm, not to increase the number of ventricular contractions.

A. pH 7.25 and HCO₃⁻ 18 mEq/L B. pH 7.30 and HCO₃⁻ 20 mEq/L C. pH 7.38 and HCO₃⁻ 24 mEq/L D. pH 7.20 and HCO₃⁻ 15 mEq/L

Correct Answer is C

Explanation

A. pH 7.25 and HCO₃⁻ 18 mEq/L. A pH of 7.25 is still acidotic, and a bicarbonate level of 18 mEq/L is below the normal range (22–26 mEq/L), indicating persistent metabolic acidosis. This suggests that ketoacidosis is not fully resolved, requiring continued insulin therapy, hydration, and electrolyte management.
B. pH 7.30 and HCO₃⁻ 20 mEq/L. While this shows partial improvement, the pH remains below 7.35, indicating ongoing mild acidosis. The bicarbonate level is still below normal, suggesting that buffering capacity is not yet fully restored. Additional treatment is required to completely normalize acid-base balance.
C. pH 7.38 and HCO₃⁻ 24 mEq/L. A pH of 7.38 falls within the normal range (7.35–7.45), indicating that acidosis has resolved. The bicarbonate level of 24 mEq/L is within normal limits, confirming that the body’s buffering system has been restored. These values suggest that ketoacidosis has resolved, and treatment has been effective.
D. pH 7.20 and HCO₃⁻ 15 mEq/L. A pH of 7.20 indicates severe metabolic acidosis, and a bicarbonate level of 15 mEq/L shows a significant loss of buffering capacity. These values suggest uncontrolled DKA or worsening acidosis, requiring urgent intervention with continued insulin therapy, fluid resuscitation, and electrolyte replacement.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has been treated for uncontrolled atrial fibrillation with cardioversion. Following the cardioversion, which assessment finding indicates to the nurse that the desired outcome was achieved?

Correct Answer is A

Explanation

Exhibits Complete the following sentence by choosing from the lists of options. A pH level of ________ and bicarbonate (HCO3-) level of________indicate a resolution of ketoacidosis.

Correct Answer is C

Explanation

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