Which cues would the nurse observe in a patient with a blood pressure of 60/40 and shock? quizlet

The nurse is caring for a patient admitted with the early stages of septic shock. The nurse assesses the patient to be tachypneic, with a respiratory rate of 32 breaths/min. Arterial blood gas values assessed on admission are pH 7.50, CO2 28 mm Hg, HCO3 26. Which diagnostic study result reviewed by the nurse indicates progression of the shock state?
A. pH 7.40, CO2 40, HCO3 24
B. pH 7.45, CO2 45, HCO3 26
C. pH 7.35, CO2 40, HCO3 22
D. pH 7.30, CO2 45, HCO3 18

A 53-year-old, 80-kg patient is admitted to the cardiac surgical intensive care unit after cardiac surgery. Four hours after admission to the surgical intensive care unit at 4 PM, the patient has stable vital signs and normal arterial blood gases (ABGs), and is placed on a T-piece for ventilatory weaning. During the nurse's 7 PM (1900) assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinus tachycardia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretions. Loud crackles are audible throughout lung fields. The nurse notifies the physician, who orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How does the nurse interpret the following blood gas levels?

pH 7.28, PaCO2 46 mm Hg, Bicarbonate 22 mEq/L, PaO2 58 mm Hg, O2 saturation 88%

a. Hypoxemia and compensated respiratory alkalosis

b. Hypoxemia and uncompensated respiratory acidosis

c. Normal arterial blood gas levels

d. Normal oxygen level and partially compensated metabolic acidosis

A 53-year-old, 80-kg patient is admitted to the cardiac surgical intensive care unit after cardiac surgery. Four hours after admission to the surgical intensive care unit at 4 PM, the patient has stable vital signs and normal arterial blood gases (ABGs) and is placed on a T-piece for ventilatory weaning. During the nurse's 7 PM (1900) assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinus tachycardia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretions. Loud crackles are audible throughout lung fields. The nurse notifies the physician, who orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. In communicating with the physician, which statement indicates the nurse understands what is likely occurring with the patient?

a. "May we have an order for cardiac enzymes? This patient is exhibiting signs of a myocardial infarction."

b. "My assessment indicates potential fluid overload."

c. "The patient is having frequent PVCs that are compromising the cardiac output."

d. "The patient is having a hypertensive crisis; what medications would you like to order?"

3. Salmonellosis

A client with salmonellosis will experience severe diarrhea, abdominal cramps, and vomiting; these symptoms last as long as 5 days after the intake of contaminated food. This disorder may be caused by Salmonella typhi or Salmonella paratyphi. The causative organism is usually present in such foods as eggs, salad dressings, and sandwich fillings. A client with listeriosis will experience severe diarrhea, fever, headache, pneumonia, meningitis, and endocarditis 3 to 21 days after infection. The symptoms of shigellosis range from cramps and diarrhea to a fatal dysentery that lasts for 3 to 14 days. Pain, vomiting, diarrhea, perspiration, headache, fever, and prostration lasting for 1 or 2 days are the symptoms of a Staphylococcus infection.

A nurse is performing physical assessment of four female clients who came for a general checkup. Which client is most at risk of developing breast cancer?
1. Client A: Age 60, family hx of breast cancer, 2 children, age of onset of menopause at 45
2. Client B: Age 60, family hx of breast cancer, no children, age of onset of menopause at 50
3. Client C: Age 60, no family hx of breast cancer, no children, age of onset of menopause at 50
4. Client D; Age 60, no family hx of breast cancer, 2 children, age of onset of menopause at 45

A nurse is assessing four different clients. Which findings depict that the client is at risk for heart disease?
1. Client A: color assessed - red, location assessed - face, area of trauma, sacrum, shoulders
2. Client B: color assessed - blue, location assessed - nail beds, lips, mouth, skin
3. Client C: color assessed - pallor, location assessed - face, conjunctivae, nail beds, palms of hand
4. Client D: color assessed - yellow-orange, location assessed - sclera, mucous membranes, skin

What is considered a dangerously low blood pressure 60 40?

Is 60 over 40 a good blood pressure?

What happens if your blood pressure is under 60?

Is 68 40 A low blood pressure?