The nurse is providing care to a client who has survived cardiac arrest Which of the following manifestations should alert the nurse to the development of PCAS?

Decreased circulation to the kidneys

Increased mental capacity

Improving respiratory function

Improvement in heart rate and blood pressure

Answer and Explanation

The Correct Answer is A

A. Decreased circulation to the kidneys: Post-cardiac arrest syndrome (PCAS) is a constellation of systemic ischemia/reperfusion injury responses that occur after return of spontaneous circulation (ROSC) following cardiac arrest. One of the manifestations of PCAS is decreased circulation to the kidneys due to the systemic hypoperfusion that occurs during cardiac arrest and the subsequent reperfusion injury that follows ROSC. This can lead to acute kidney injury (AKI) in some cases.

B. Increased mental capacity: While it is crucial to monitor neurological status after cardiac arrest, an immediate increase in mental capacity is not typically indicative of PCAS. Rather, neurological assessment may involve evaluating for signs of brain injury or dysfunction, which can include altered mental status, confusion, or neurological deficits.

C. Improving respiratory function: Improvement in respiratory function after cardiac arrest is a positive sign but may not necessarily indicate the development of PCAS. PCAS primarily involves systemic responses to the ischemia/reperfusion injury that occurs during and after cardiac arrest, rather than isolated respiratory changes.

D. Improvement in heart rate and blood pressure: Improvement in heart rate and blood pressure after cardiac arrest is generally expected with successful resuscitation efforts. However, these improvements alone may not necessarily indicate the development of PCAS. PCAS involves a broader range of systemic responses beyond just cardiac and hemodynamic changes.

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Correct Answer is C

Explanation

A. Relocation stress syndrome: Relocation stress syndrome refers to the physical and psychological symptoms experienced by individuals when they are moved from one environment to another, such as transitioning to a new residence or healthcare facility. While relocation stress syndrome can cause agitation and confusion in individuals with Alzheimer's disease, the scenario provided does not indicate a recent relocation.

B. Wandering: Wandering is a common behavior observed in individuals with dementia, where they aimlessly roam or wander in their environment. While wandering may be associated with agitation and restlessness, the scenario does not describe the client physically moving around or attempting to leave their home.

C. Sundowning: Sundowning refers to a phenomenon commonly observed in individuals with Alzheimer's disease or other forms of dementia, where they experience increased agitation, confusion, and restlessness in the late afternoon or early evening hours. Sundowning behaviors can include pacing, agitation, anxiety, irritability, confusion, and difficulty sleeping. The exact cause of sundowning is not fully understood but may be related to factors such as fatigue, sensory overload, hormonal imbalances, or disruptions in the sleep-wake cycle. Managing sundowning behaviors often involves creating a calming environment, maintaining a consistent daily routine, minimizing stimuli in the evening, and providing reassurance and comfort to the individual.

D. Depression: Depression can occur in individuals with Alzheimer's disease and may present with symptoms such as sadness, hopelessness, loss of interest in activities, changes in appetite or sleep patterns, and difficulty concentrating. However, the scenario primarily describes agitation and restlessness in the evening hours, which is characteristic of sundowning rather than depression.

A. Comply with compression therapy. B. Monitor wounds on lower extremities. C. Take antiplatelet medications as ordered. D. Monitor for gradual onset of symptoms

Correct Answer is D

Explanation

A. Comply with compression therapy:

Compression therapy typically refers to the use of compression garments or devices to improve circulation and reduce swelling in the extremities, particularly in conditions such as venous insufficiency or deep vein thrombosis.

While compression therapy may be beneficial for certain circulatory disorders, it is not a standard treatment for cardiac tamponade.

Cardiac tamponade is a medical emergency characterized by the accumulation of fluid in the pericardial sac, leading to increased pressure on the heart and impaired cardiac function.

Treatment for cardiac tamponade involves prompt recognition and intervention to relieve the pressure on the heart, such as pericardiocentesis or surgical drainage of the pericardial effusion.

B. Monitor wounds on lower extremities:

Monitoring wounds on the lower extremities is essential for assessing healing, preventing complications such as infection, and promoting overall wound care.

However, monitoring wounds on the lower extremities is not directly related to the management or monitoring of cardiac tamponade.

In cardiac tamponade, the focus of monitoring is on assessing signs and symptoms of cardiac compromise, such as hypotension, tachycardia, dyspnea, and pulsus paradoxus, rather than wound care.

C. Take antiplatelet medications as ordered:

Antiplatelet medications, such as aspirin or clopidogrel, are commonly prescribed to prevent platelet aggregation and reduce the risk of thrombotic events, particularly in patients with cardiovascular disease or a history of myocardial infarction or stroke.

While antiplatelet medications may be part of the long-term management of certain cardiac conditions, they are not specific to the treatment or monitoring of cardiac tamponade.

The primary treatment for cardiac tamponade involves interventions to relieve the pressure on the heart and restore cardiac function, such as pericardiocentesis or surgical drainage of the pericardial effusion.

D. Monitor for gradual onset of symptoms:

Phase II of cardiac tamponade is characterized by a gradual onset of symptoms as the pressure within the pericardial sac increases, leading to impaired cardiac filling and decreased cardiac output.

Symptoms may include dyspnea, fatigue, orthopnea, tachycardia, and chest discomfort, which may develop gradually over time.

Early recognition of symptoms is crucial for prompt diagnosis and intervention to prevent further deterioration and improve outcomes in patients with cardiac tamponade.

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The nurse is providing care to a client who has survived cardiac arrest Which of the following manifestations should alert the nurse to the development of PCAS?

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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