When assessing the hemodynamic information for a newly admitted patient in shock of unknown etiology, the emergency department nurse will anticipate the administration of large volumes of Lactated Ringers (LR) when which one of the following occurs?

The mean arterial pressure (MAP) is 50 mm Hg.

Cardiac Out (CO) is 4 L/min

Stroke volume 70 ml/beat

The heart rate is 80 bpm.

Answer and Explanation

The Correct Answer is A

Mean arterial pressure (MAP) is a measure of the average pressure within the arteries during one cardiac cycle. It represents the perfusion pressure that drives blood flow to organs and tissues. In the context of shock, a MAP of 50 mm Hg is considered low and indicates inadequate tissue perfusion.
To improve tissue perfusion and restore blood pressure, the nurse would anticipate administering large volumes of intravenous fluids, such as Lactated Ringers (LR). Fluid resuscitation aims to increase intravascular volume and improve cardiac output, ultimately leading to improved tissue perfusion.
B. Cardiac Output (CO) is 4 L/min in (option A) is incorrect because Cardiac output represents the volume of blood pumped by the heart per minute. While a low cardiac output may require intervention, it does not specifically indicate the need for large volumes of fluid administration.
C. Stroke volume is 70 ml/beat in (option C) is incorrect because Stroke volume refers to the volume of blood ejected by the heart with each contraction. While stroke volume can be an important determinant of cardiac output, it alone does not indicate the need for large fluid volumes.
D. The heart rate is 80 bpm in (option D) is incorrect because: Heart rate is the number of heartbeats per minute. While the heart rate can impact cardiac output, it does not provide direct information about fluid resuscitation needs.

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Correct Answer is B

Explanation

Positioning the transducer level with the phlebostatic axis is a crucial step in accurate hemodynamic monitoring. The phlebostatic axis is an imaginary reference point located at the fourth intercostal space, mid-anterior/posterior chest. Placing the transducer at this level ensures that the pressure measurements obtained are reflective of the patient's true hemodynamic status.
A. Positioning the limb with the catheter insertion site at the level of the transducer in (option A) is incorrect because: While it is important to position the limb appropriately to avoid kinks or occlusions in the catheter tubing, this is not directly related to the accurate measurement of hemodynamic parameters.
C. Ensuring that the patient is lying with the head of the bed flat for all readings in (option C) is incorrect because The position of the patient's head does not directly impact the accuracy of hemodynamic monitoring unless it specifically relates to changes in preload or intracranial pressure monitoring.
D. Balancing and calibrating the hemodynamic monitoring equipment every hour in (option D) is incorrect because: While it is important to ensure that the monitoring equipment is calibrated and functioning properly, doing so every hour may not be necessary. Calibration frequency may vary based on institutional policies and patient stability.
Therefore, the correct action that demonstrates effective teaching about hemodynamic monitoring is positioning the transducer level with the phlebostatic axis.

Correct Answer is ["9"]

Explanation

Doseinmcg/min=2mcg/kg/min×60kg=120mcg/min

Convert this to mg/min since the concentration is in mg:

120mcg/min=0.12mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120mcg/min=0.12mg/min
Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200mg250mL=0.8mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250mL200mg=0.8mg/mL
Calculate the pump rate in mL/min:

To find the rate in mL/min needed to deliver 0.12 mg/min:

Pumprate=Desireddose(mg/min)Concentration(mg/mL)\text{Pump rate} = \frac{\text{Desired dose (mg/min)}}{\text{Concentration (mg/mL)}}Pumprate=Concentration(mg/mL)Desireddose(mg/min)

Pumprate=0.12mg/min0.8mg/mL=0.15mL/min\text{Pump rate} = \frac{0.12 \text{ mg/min}}{0.8 \text{ mg/mL}} = 0.15 \text{ mL/min}Pumprate=0.8mg/mL0.12mg/min=0.15mL/min
Convert the pump rate to mL/hour:

Multiply by 60 to convert from mL/min to mL/hour:

Pumprate=0.15mL/min×60min/hour=9mL/hour\text{Pump rate} = 0.15 \text{ mL/min} \times 60 \text{ min/hour} = 9 \text{ mL/hour}Pumprate=0.15mL/min×60min/hour=9mL/hour

So, you should set the pump to deliver Dopamine at a rate of 9 mL/hour.

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When assessing the hemodynamic information for a newly admitted patient in shock of unknown etiology, the emergency department nurse will anticipate the administration of large volumes of Lactated Ringers (LR) when which one of the following occurs?

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Naxlex Comprehensive Predictor Exams

The ICU charge nurse will evaluate that teaching about hemodynamic monitoring for a new staff nurse has been effective when the new nurse does which of the following?

Correct Answer is B

Explanation

Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)

Correct Answer is ["9"]

Explanation

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