A nurse is caring for a group of patients. Which patient should the nurse see first?
A patient with hypercapnia wearing an oxygen mask
A patient with a chest tube ambulating with the chest tube unclamped
A patient with thick secretions being tracheal suctioned first and then orally
A patient with a new tracheostomy and tracheostomy obturator at bedside
The Correct Answer is B
A. A patient with hypercapnia requires monitoring, but wearing an oxygen mask indicates some level of intervention is in place.
B. A patient with a chest tube should never ambulate with the chest tube unclamped, as this can lead to a collapsed lung and respiratory distress; thus, this patient should be prioritized.
C. While a patient with thick secretions may need suctioning, this is not as critical as ensuring the safety of a patient with an unclamped chest tube.
D. A patient with a new tracheostomy requires monitoring, but the presence of the obturator indicates readiness for emergencies; this does not take priority over the safety of the patient with the chest tube.
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Correct Answer is A
Explanation
A. The P wave represents atrial depolarization, which is initiated by the SA node, the heart's natural pacemaker.
B. The AV node is responsible for conducting impulses from the atria to the ventricles but does not initiate the P wave.
C. The Bundle of His transmits the electrical impulses to the ventricles but is not directly associated with the P wave.
D. Purkinje fibers are involved in ventricular depolarization, which corresponds to the QRS complex, not the P wave.
Correct Answer is D
Explanation
A. An increase in heart rate does not directly affect hemoglobin levels; this option is incorrect.
B. A higher heart rate decreases diastolic filling time, as there is less time for the heart to fill between beats, which can lead to reduced stroke volume.
C. An increased heart rate does not inherently increase stroke volume; in fact, at very high rates, stroke volume can decrease due to reduced filling time.
D. The significant increase in heart rate to 164 beats/min can lead to decreased cardiac output due to compromised diastolic filling and reduced stroke volume.