Complex Adult Health final QUESTIONS AND ANSWERS 100%
CORRECT
Indication for arterial line placement? Correct Answer: 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? Correct Answer: Allen's test
How often should a fast flush test be preformed? Correct Answer: Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? Correct Answer: Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: Correct Answer: 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? Correct Answer: Every 7 days
Causes of inaccuracy in arterial line readings: Correct Answer: 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? Correct Answer: The pressure in which the heart must pump against
in order to eject blood during systole.
Medications that reduce afterload/preload include? Correct Answer: Vasodilators
What is the pathology of preload? Correct Answer: The filling pressure of the heart at end of diastole.
What is systemic vascular resistance (SVR)? Correct Answer: 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? Correct Answer: Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? Correct Answer: 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)? Correct Answer: The pressure created by the
volume of blood that remains in the left heart at end-diastole.
Inotropic drugs mode of action: Correct Answer: Negative inotropic drugs weaken the force of muscular
contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: Correct Answer: Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: Correct Answer: Relaxes the smooth muscles of the blood vessels opening
them up.
Vasodilator drug examples: Correct Answer: CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
Lisinopril (Prinivil, Zestril)
Kayexalate Correct Answer: Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate Correct Answer: Prevents and treats cardiac toxicity related to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)? Correct Answer: 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 Correct Answer: Delivers blood to the kidneys.
A prerenal block is: Correct Answer: An interruption on the way to the kidneys.
The intrarenal system Correct Answer: Processes ultra-filtrate by tubular secretion & re-absorption.
, An intrarenal block is: Correct Answer: Direct damage to the kidneys.
The postrenal system Correct Answer: Excretes kidney waste products through the ureters, bladder,
and urethra.
A postrenal block is: Correct Answer: Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): Correct Answer: <400 mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): Correct Answer: Urine output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): Correct Answer: Cr >1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
S/SX of the injury stage of acute kidney injury (AKI): Correct Answer: Cr >2xbaseline
Urine output <0.5ml/kg/hr for 12+ hours
S/SX of the risk failure of acute kidney injury (AKI): Correct Answer: Cr >3xbaseline
Urine output <0.3ml/kg/hr for 12+ hours
Priority assessment findings of acute kidney injury (AKI): Correct Answer: Respiratory:
Crackles
Pleural Effusion
Kussmaul respirations
Cardiovascular:
CHF, hypo/hypertension
Cardiac dysrhythmias
Pericarditis, pericardial effusion
Neurologic:
Altered mentation, confusion, lethargy
Decreased seizure threshold
S/SX of hypovolemic shock: Correct Answer: Elevated HR, decreased BP, tachypnea, oliguria, cool pale
skin, decreased mental status, flat neck veins, decreased CO CI RAP PAP PAOP, elevated SVR, decreased
SvO2.
Dehydration causes elevated HCT
Blood loss causes decreased HCT
Possible causes of hypovolemic shock: Correct Answer: External loss of blood
CORRECT
Indication for arterial line placement? Correct Answer: 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? Correct Answer: Allen's test
How often should a fast flush test be preformed? Correct Answer: Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? Correct Answer: Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: Correct Answer: 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? Correct Answer: Every 7 days
Causes of inaccuracy in arterial line readings: Correct Answer: 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? Correct Answer: The pressure in which the heart must pump against
in order to eject blood during systole.
Medications that reduce afterload/preload include? Correct Answer: Vasodilators
What is the pathology of preload? Correct Answer: The filling pressure of the heart at end of diastole.
What is systemic vascular resistance (SVR)? Correct Answer: 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? Correct Answer: Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? Correct Answer: 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)? Correct Answer: The pressure created by the
volume of blood that remains in the left heart at end-diastole.
Inotropic drugs mode of action: Correct Answer: Negative inotropic drugs weaken the force of muscular
contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: Correct Answer: Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: Correct Answer: Relaxes the smooth muscles of the blood vessels opening
them up.
Vasodilator drug examples: Correct Answer: CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
Lisinopril (Prinivil, Zestril)
Kayexalate Correct Answer: Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate Correct Answer: Prevents and treats cardiac toxicity related to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)? Correct Answer: 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 Correct Answer: Delivers blood to the kidneys.
A prerenal block is: Correct Answer: An interruption on the way to the kidneys.
The intrarenal system Correct Answer: Processes ultra-filtrate by tubular secretion & re-absorption.
, An intrarenal block is: Correct Answer: Direct damage to the kidneys.
The postrenal system Correct Answer: Excretes kidney waste products through the ureters, bladder,
and urethra.
A postrenal block is: Correct Answer: Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): Correct Answer: <400 mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): Correct Answer: Urine output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): Correct Answer: Cr >1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
S/SX of the injury stage of acute kidney injury (AKI): Correct Answer: Cr >2xbaseline
Urine output <0.5ml/kg/hr for 12+ hours
S/SX of the risk failure of acute kidney injury (AKI): Correct Answer: Cr >3xbaseline
Urine output <0.3ml/kg/hr for 12+ hours
Priority assessment findings of acute kidney injury (AKI): Correct Answer: Respiratory:
Crackles
Pleural Effusion
Kussmaul respirations
Cardiovascular:
CHF, hypo/hypertension
Cardiac dysrhythmias
Pericarditis, pericardial effusion
Neurologic:
Altered mentation, confusion, lethargy
Decreased seizure threshold
S/SX of hypovolemic shock: Correct Answer: Elevated HR, decreased BP, tachypnea, oliguria, cool pale
skin, decreased mental status, flat neck veins, decreased CO CI RAP PAP PAOP, elevated SVR, decreased
SvO2.
Dehydration causes elevated HCT
Blood loss causes decreased HCT
Possible causes of hypovolemic shock: Correct Answer: External loss of blood
