CCRN-Adult Exam Dumps : CCRN (Adult) - Direct Care Eligibility Pathway

For a patient with unstable angina, the major goal of treatment is to decrease myocardial oxygen consumption. This can be achieved by reducing heart rate, blood pressure, and myocardial contractility to lessen the workload on the heart and reduce the demand for oxygen. This helps in preventing further ischemia and potential myocardial infarction. Treatment strategies may include the use of medications such as beta-blockers, nitrates, and calcium channel blockers, which all help in decreasing the oxygen demand of the heart.References: = CCRN Exam Handbook, page 10

The spleen plays a crucial role in filtering bacteria and old or damaged blood cells, as well as mounting an immune response. After a splenectomy, the patient is at increased risk for infections, particularly from encapsulated organisms like Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. This heightened susceptibility to infection can lead to sepsis, a life-threatening condition. References: AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.

The patient’s data indicate that the patient is in shock, which is a life-threatening condition characterized by inadequate tissue perfusion and organ dysfunction. The patient has a low blood pressure, a high heart rate, a fever, and a metabolic acidosis, which suggest that the patient may have septic shock, which is caused by a severe infection that triggers a systemic inflammatory response. The nurse should anticipate an order to administer phenylephrine (Neo-Synephrine), which is a vasopressor agent that constricts the blood vessels and increases the blood pressure and tissue perfusion. Phenylephrine is recommended as a first-line agent for septic shock by the Surviving Sepsis Campaign guidelines1. 8.4% sodium bicarbonate is not indicated for the treatment of septic shock, as it may worsen the acid-base balance and increase the risk of complications2. 0.9% sodium chloride is a normal saline solution that may be used for fluid resuscitation, but it may not be sufficient to restore the blood pressure and may cause fluid overload, hyperchloremia, and kidney injury3. Amiodarone (Cordarone) is an antiarrhythmic drug that is used to treat ventricular tachycardia or fibrillation, but it is not effective for septic shock and may cause hypotension, bradycardia, and other adverse effects4.

References:

• Surviving Sepsis Campaign. (2020). Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Retrieved from 1, p. 16.
• Marik, P. E., & Bellomo, R. (2013). A rational approach to fluid therapy in sepsis. British Journal of Anaesthesia, 110(3), 323-329. Retrieved from 2, p. 327.
• Semler, M. W., & Rice, T. W. (2019). Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial. Trials, 20(1), 1-10. Retrieved from 3, p. 2-3.
• Lexicomp Online. (2021). Amiodarone. Retrieved from 4, p. 1-2.