Ventricular Assist Devices:
Assessment and Treatment
Considerations (ALS) Exam Questions
& Answers (Grade A+)
You are treating a VAD patient with suspected GI bleeding. He is
pale and diaphoretic, with pale mucous membranes and an etCO2
of 24 mmHg. He is somewhat lethargic, and answers "Yes" or "No"
questions only with difficulty. His medications are warfarin and
digoxin, and the cardiac monitor reveals atrial fibrillation at 128
bpm. You have managed to obtain a mean arterial pressure of
roughly 50 mmHg by using your NIBP machine. Auscultation of the
chest reveals that his VAD is running, although the external
controller shows a "LOW FLOW" alarm. After consultation with the
VAD Coordinator at the hospital, you establish vascular access and
administer, per her instructions, boluses of normal saline at 250 ml,
titrated to a MAP of 65 mmHg. In this patient, what is your greatest
concern with this treatment plan? -
correct answer ✅Fluid overload due to his weakened heart
A patient tells you that he has a BiVAD. This means that: -
correct answer ✅his device is grafted to both the right and left
ventricles, augmenting the function of each.
Your VAD patient is unconscious and apneic, with pale, cool skin.
You cannot detect a pulse or obtain a blood pressure. Your first step
should be to: -
Assessment and Treatment
Considerations (ALS) Exam Questions
& Answers (Grade A+)
You are treating a VAD patient with suspected GI bleeding. He is
pale and diaphoretic, with pale mucous membranes and an etCO2
of 24 mmHg. He is somewhat lethargic, and answers "Yes" or "No"
questions only with difficulty. His medications are warfarin and
digoxin, and the cardiac monitor reveals atrial fibrillation at 128
bpm. You have managed to obtain a mean arterial pressure of
roughly 50 mmHg by using your NIBP machine. Auscultation of the
chest reveals that his VAD is running, although the external
controller shows a "LOW FLOW" alarm. After consultation with the
VAD Coordinator at the hospital, you establish vascular access and
administer, per her instructions, boluses of normal saline at 250 ml,
titrated to a MAP of 65 mmHg. In this patient, what is your greatest
concern with this treatment plan? -
correct answer ✅Fluid overload due to his weakened heart
A patient tells you that he has a BiVAD. This means that: -
correct answer ✅his device is grafted to both the right and left
ventricles, augmenting the function of each.
Your VAD patient is unconscious and apneic, with pale, cool skin.
You cannot detect a pulse or obtain a blood pressure. Your first step
should be to: -
