A patient's CVP reading suddenly increased from 10 to 48 mm Hg. ...

[dbose]

A patient's CVP reading suddenly increased from 10 to 48 mm Hg. His lungs are clear except for fine rales at the bases. Immediate response should be which of the following?
 
  a. Nothing; this reading is still within normal limits.
  b. Place a stat call into the physician.
  c. Administered ordered prn Lasix.
  d. Check the transducer level.

Question 2

A patient who has type 2 diabetes is on the unit after aneurysm repair. His serum glucose levels have been elevated for the past 2 days. He is concerned that he is becoming dependent on insulin. The best response for the nurse would be
 
  a. This surgery may have damaged your pancreas. We will have to do more evaluation.
  b. Perhaps your diabetes was more serious from the beginning.
  c. You will need to discuss this with your physician.
  d. The stress on your body has temporarily increased your blood sugar levels.

[ghepp]

Answer to Question 1

D
If the transducer falls below the correct level, the reading would be falsely elevated. This rise is consistent with a transducer having fallen from the correct level on the bed to the floor. Lasix is not indicated. Central venous pressure (CVP) of 45 mm Hg, if true, is severely elevated. Not enough information has been provided to call the physician. If the CVP value is true and the patient's condition is poor, a call to the physician would be appropriate after assessment.

Answer to Question 2

D
Adrenal hormones released during stress elevate blood sugar by increasing insulin resistance and increasing hepatic gluconeogenesis.

[dbose]

Excellent

[Jossy]

TYSM