NR 341 Complex Adult Health Final Exam – Questions
With Solutions
Indication for arterial line placement? Right Ans - Hemodynamic
monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
What test must be preformed prior to an arterial line placement? Right Ans
- Allen's test
How often should a fast flush test be preformed? Right Ans - Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? Right Ans -
Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: Right Ans - 30-60 degrees of
dorsiflexion with the aid of a roll of gauze and an armband.
Avoid hyperabduction of the thumb.
How often should the atrial line catheter be changed out? Right Ans - Every
7 days
Causes of inaccuracy in arterial line readings: Right Ans - Air bubbles in the
catheter system
Failure to zero the transducer air-fluid interface
Blood in the catheter system
Blood clot at the catheter tip
Kinking of the tubing system
Catheter tip lodging against the arterial wall
,Soft, compliant tubing
Long tubing
Too many stopckcks (>3)
What is the pathology of afterload? Right Ans - The pressure in which the
heart must pump against in order to eject blood during systole.
Medications that reduce afterload/preload include? Right Ans -
Vasodilators
What is the pathology of preload? Right Ans - The filling pressure of the
heart at end of diastole.
What is systemic vascular resistance (SVR)? Right Ans - Resistance the left
ventricle must overcome to open the aortic valve and eject a volume of blood
into systemic circulation.
Systemic vascular resistance (SVR) is used for what calculations? Right Ans
- Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? Right Ans - Resistacne the
right ventricle must overcome to open the pulmonic valve and eject a volume
of blood in the pulmonary vasculature.
What is pulmonarartery occlusion pressure (PAOP)? Right Ans - The
pressure created by the volume of blood that remains in the left heart at end-
diastole.
Inotropic drugs mode of action: Right Ans - Negative inotropic drugs
weaken the force of muscular contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: Right Ans - Dobutamine
Digoxin
Milrinone
Dopamine
, Vasodilator mode of actions: Right Ans - Relaxes the smooth muscles of the
blood vessels opening them up.
Vasodilator drug examples: Right Ans - CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
Lisinopril (Prinivil, Zestril)
Kayexalate Right Ans - Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate Right Ans - Prevents and treats cardiac toxicity related
to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)?
Right Ans - Dialysis
This is a blood filtering therapy that replaced the normal blood-filtering
function of the kidneys in patients with renal failure and acute kidney injuries.
The prerenal system Right Ans - Delivers blood to the kidneys.
A prerenal block is: Right Ans - An interruption on the way to the kidneys.
The intrarenal system Right Ans - Processes ultra-filtrate by tubular
secretion & re-absorption.
An intrarenal block is: Right Ans - Direct damage to the kidneys.
The postrenal system Right Ans - Excretes kidney waste products through
the ureters, bladder, and urethra.
A postrenal block is: Right Ans - Obstruction of urine output.
Causes:
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