Hemodynamic Monitoring and Management Flashcards
6 cards from real Acute Care Nurse Practitioner practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Hemodynamic Monitoring and Management flashcards as text
Which inotrope is MOST appropriate for a patient in cardiogenic shock with severe hypotension (MAP 55 mmHg)?
Answer: Norepinephrine + dobutamine
Norepinephrine provides vasopressor support to raise MAP while dobutamine adds inotropic effect in cardiogenic shock with hypotension.
A patient with right heart failure has which expected hemodynamic pattern?
Answer: High CVP, low PAOP, low CO
Right heart failure causes elevated CVP from backward congestion but low PAOP and low CO from inadequate left-sided filling.
An ACNP is titrating vasopressors for a patient with refractory septic shock. Which adjunctive agent has been shown to reduce vasopressor requirements?
Answer: Hydrocortisone 200 mg/day
Hydrocortisone 200 mg/day is recommended for vasopressor-refractory septic shock as it reduces vasopressor requirements.
Which device provides direct measurement of cardiac output via thermodilution?
Answer: Pulmonary artery catheter
The pulmonary artery catheter (Swan-Ganz) measures cardiac output via thermodilution using cold saline injection.
A patient on vasopressors has digital ischemia developing in multiple extremities. Which intervention is MOST appropriate?
Answer: Wean vasopressors to the lowest effective dose and consider phentolamine
Vasopressor-induced ischemia requires weaning to the lowest effective dose; phentolamine (alpha blocker) can be used for severe digital ischemia.
Which condition is characterized by high cardiac output, low SVR, and low-to-normal CVP?
Answer: Distributive shock
Distributive shock (e.g., sepsis, anaphylaxis) causes massive vasodilation, resulting in high CO, low SVR, and relative hypovolemia.