Exam 66: Nursing Management: Critical Care

A patient with hemodynamic monitoring has a blood pressure of 94/68, heart rate of 130, and a cardiac output (CO) of 4.8 L/min. In analyzing the patient's hemodynamic measurements, the nurse calculates the stroke volume (SV) at ____ ml/beat.

The nurse is caring for a patient receiving a continuous norepinephrine (Levophed) IV infusion. Which patient assessment information indicates that the infusion rate may be too high?

A patient with acute respiratory failure is receiving assist-control mechanical ventilation with peak end-expiratory pressure (PEEP) of 10 cm H₂O and has an arterial line and pulmonary artery catheter in place. Which information indicates that a change in the ventilator settings may be required?

A patient with chronic obstructive pulmonary disease (COPD) is in acute respiratory failure and has been placed on mechanical ventilation. Four hours after mechanical ventilation is initiated, the patient's ABG results include a pH of 7.50, PaO₂ of 80 mm Hg, PaCO₂ of 29 mm Hg, and HCO₃- of 23 mEq/L (23 mmol/L). The nurse will anticipate the need to

A patient admitted to the ICU after experiencing a massive pulmonary embolism has an arterial catheter and a pulmonary artery catheter in place. When evaluating whether treatment has been effective in improving pulmonary hypertension, the nurse will monitor for

A patient with severe heart failure has a ventricular assist device (VAD) implanted. When developing the plan of care, the nursing actions should include

The nurse notes that a patient's endotracheal tube (ET), which was at the 21-cm mark, is now at the 24-cm mark and the patient appears anxious and restless. Which action should the nurse take first?

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

While suctioning a patient with an endotracheal tube (ET), the nurse notes the occurrence of premature ventricular contractions (PVCs) on the patient's cardiac monitor. The most appropriate action by the nurse upon this finding is to

The nurse identifies a collaborative problem of potential for arterial trauma secondary to displacement of the balloon for a patient with an intraaortic balloon pump (IABP). An appropriate action by the nurse for this problem is to

An elderly patient who has been in the ICU for a week is preparing for transfer to the step-down unit when the nurse notices that the patient has new-onset restlessness and confusion. The patient's physiologic status is stable and otherwise unchanged. The nurse should

A patient has an arterial pressure catheter placed in the right radial artery for access for frequent arterial sampling for blood gas analysis. When the low-pressure alarm is activated, the nurse's most appropriate action would be to

Which action by a new RN working in the ICU indicates that the education regarding care of the patient receiving manual ventilation with 10 cm of PEEP has been effective?

When the nurse is weaning a patient who has COPD from mechanical ventilation, which patient assessment indicates that the weaning protocol should be discontinued?

A patient with a subarachnoid hemorrhage is intubated and placed on a mechanical volume-cycled ventilator in the spontaneous intermittent mandatory volume (SIMV) mode, FIO₂ 40%, rate 14, VT 700, with 10 cm of PEEP. When monitoring the patient, the nurse will need to notify the health care provider if the patient develops

To verify the correct placement of an endotracheal tube (ET) after insertion, the best initial action for the nurse to take is

Which assessment information obtained by the nurse when caring for a patient receiving mechanical ventilation indicates the need for suctioning?

While assessing a patient with a central venous catheter in place in the left subclavian vein, the nurse notes the catheter insertion site is red and tender and the patient's temperature is 101.8° F. The nurse will plan to