A nurse educator is teaching a group of nurses at a long-term ...

[saraeharris]

A nurse educator is teaching a group of nurses at a long-term care facility about atrial fibrillation in light of its prevalence in older adults. Which of the following statements by the nurses would the educator most want to correct?
 
  A)
  The electrical impulses go in chaotic directions, and so the atria can't contract properly.
  B)
  An ECG of someone in atrial fibrillation would be almost random in appearance.
  C)
  The contraction of the ventricles and the atria can range from 400 to 600 beats/minute.
  D)
  It can be hard to measure at the bedside because not all ventricular beats make a palpable pulse.

Question 2

While assessing a patient with urosepsis, the ICU nurse notes the patient's BP is 80/54; HR 132; RR 24; and pulse oximetry 89 on 6 lpm O2.
 
  Over the last hour, the patient's urine output is 15 mL. When explaining to a new graduate nurse, the nurse will emphasize that the patient's status may relate to that
  A)
  the infection is deep inside the kidney, and it will take a long time for the antibiotics to kill the bacteria.
  B)
  the patient's sympathetic nervous system has been stimulated that has resulted in vasoconstriction of the afferent arteriole, which causes a decrease in renal blood flow.
  C)
  the glomerular filtration system gets overwhelmed in times of stress (like infections) and can become clogged with waste material from the bacteria.
  D)
  the ability to transport substances from the tubular fluid into the peritubular capillaries becomes impaired, which results in fluid being forced out of capillaries into the glomerulus.

[cadimas]

Answer to Question 1

Ans:
C

Feedback:

While atrial contraction can range from 400 to 600 beats/minute, ventricular contraction is normally in the range of 80 to 180 beats/ minute during atrial fibrillation. The electrical impulses do go in chaotic, inappropriate directions, and the ECG can appear random. Measurement can be challenging because of the lack of pulses corresponding to all ventricular contractions.

Answer to Question 2

Ans:
B

Feedback:

During periods of strong sympathetic stimulation, such as shock, constriction of the afferent arteriole causes a marked decrease in renal blood flow and thus glomerular filtration pressure. Consequently, urine output can fall almost to zero.

[saraeharris]

Thank you

[cadimas]

No problemo