ATI MED SURG VERSION 7 ACTUAL EXAM

ATI MED SURG VERSION 7 ACTUAL EXAM What are two medications that are prescribed for pharmacological stress test - ANSWER-Dobutamine Adenosine What do you instruct the patient to do 2 to 4 hours before a stress test - ANSWERAvoid tobacco, alcohol and caffeine Hemodynamic monitoring involves special indwelling catheters that provide information about blood volume and perfusion, fluid status and how well the heart is pumping. Arterial lines are placed in the radial (most common), brachial or femoral artery. What should you Monitor for? - ANSWER-Monitor circulation in the limb with the arterial line. Such as capillary refill, temperature, color. Arterial lines are not used for IV fluid administration The pulmonary artery (PA) catheter is inserted into a large vein (internal jugular, femoral, subclavian, brachial) and threaded through the right atria and ventricles into a branch of the pulmonary artery. PA catheters have multiple lumens, ports and components that allow for various hemodynamic measurements, blood sampling and - ANSWER-Infusion of IV fluids What are the different lumens used for? - ANSWERWhat is the expected reference range for CVP (Central venous pressure) - ANSWER-1 to 8 MM HG What is the expected reference range for pulmonary artery systolic (PAS) - ANSWER15 to 26 What is the expected range for pulmonary artery diastolic (PAD) - ANSWER-5 to 15 What is expected range for pulmonary artery wedge pressure (PAWP)? - ANSWER-4 to 12 What is the expected range for cardiac output - ANSWER-4 to 7 L/minute What is expected range for mixed venous oxygen saturation - ANSWER-60% to 80% When should a nurse anticipate lower hemodynamic values? - ANSWER-In older patients especially if dehydration is a complication What position should the patient be in with hemodynamic monitoring - ANSWER-Supine or Trendelenburg What is normal range for cholesterol, HDL, LDL - ANSWER-Less than 200, above 40, less than 130 What is the desired INR range for people taking warfarin - ANSWER-2.0-3.0 What is an indicator of cardiac tamponade - ANSWER-Blood pressure is 10 MM HG or higher on expiration then on inspiration Patients scheduled for a coronary artery bypass graft should not take anticoagulants for at least blank prior to the surgery to prevent excessive bleeding - ANSWER-A week A patient is admitted with a diagnosis of Bradydysrhythmia. What assessment finding requires immediate intervention? - ANSWER-The patient reports weakness and fatigue Following insertion of a permanent pacemaker, a patient states they cannot get rid of these hiccups. Why is this potentially a problem? - ANSWER-Hiccups may indicate that the pacemaker is stimulating the chest wall or diaphragm. This could indicate a complication such as lead wire perforation Chapter 27 - ANSWERWhat is the normal range for creatine kinase? When are elevated levels first detectable after myocardial injury and what is expected duration of the elevated levels? - ANSWER-30 to 170 units/L, 4 to 6 hours, 3 days What is the normal range for troponin T? When are elevated levels first detectable after myocardial injury and what is expected duration of the elevated levels? - ANSWERLess than 0.2 ng/L, 3 to 5 hours, 14 to 21 days What is normal range for troponin I? When are elevated levels first detectable after myocardial injury and what is expected duration of the elevated levels? - ANSWERLess than 0.03, three hours, 7 to 10 days What is normal range for myoglobin? When are elevated levels first detectable after myocardial injury and what is expected duration of the elevated levels? - ANSWERLess than 90 mcg/L, two hours, 24 hours While an echocardiogram is being performed what side should the patient lie on? - ANSWER-Left side and remain still