for question #15, I immediately removed choice C because pt. is hypotensive and one of the options was vasodilators in C. Can you explain why this would still be the correct answer, considering that a vasodilator would potentially make the hypotension worse? I understand that this pt. is presenting as cardiogenic shock/HF and would need preload and afterload reduction, but was thrown off by other data in the question. Thanks in advane!
My apologies for the late reply. This is one of those questions where you have to choose the best answer given the information you have. You're totally correct in saying that diuretics would probably cause further hypotension (which we definitely don't want!). However, the two goals in cardiogenic shock include enhancing effectiveness of the pump and decreasing demand on the pump. in looking at the other answer choices, they all have at least one part that does not meet those goals (A-negative inotrope, B-beta blocker, D-adenosine); but C does meet the treatment goals of cardiogenic shock. In real life, we would certainly use diuretics conservatively and make sure the patient can tolerate them. Hope that helps! :)
Ha same - was wrecking my brain trying to make sense of it. Also missed the one that asked which patient could benefit from antibiotics and didn’t even have septic shock run thru my mind lol
For question #14 the correct answer makes sense, but I did also want to ask this: COPD causes barrel chest and increased intrathoracic pressure decreases R heart filling. For this reason, I thought low CVP could have been the answer
I do see where you are coming from; great thought process! I'll have to look a little bit more into this but my idea constructing this question was focusing on the "chronic" emphysema/COPD, wherein over time, the pulmonary HTN is going to lead to R heart failure (constant backup of blood, elevated CVP) If I find out a better pathophysiology answer, I will let you know!
Unfortunately I do not have a test bank. I do recommend Barron's full tests (read the rationales!). I did get a 150-question test from AACN (I can't remember if it was free with the test purchase or because I also bought the AACN question bank) but I did like their 150-question test and rationales!
For question #11, I am confused because the treatment for it in your chart also says afterload reducers and when I look into what reduces afterload, it is nitrates reduce afterload. So, why isn’t the answer also B?
While nitrates may reduce afterload at higher dosages, they primarily reduce preload. IABP would be the best choice for this patient who is in cardiogenic shock!
Passed my exam today 🎉. Thank you
Great job! 💕🎉
I found your videos a week before taking my exam and found them so incredibly helpful! I passed with better scores than expected!
That is so wonderful, congratulations! ☺️
for question #15, I immediately removed choice C because pt. is hypotensive and one of the options was vasodilators in C. Can you explain why this would still be the correct answer, considering that a vasodilator would potentially make the hypotension worse? I understand that this pt. is presenting as cardiogenic shock/HF and would need preload and afterload reduction, but was thrown off by other data in the question. Thanks in advane!
My apologies for the late reply. This is one of those questions where you have to choose the best answer given the information you have. You're totally correct in saying that diuretics would probably cause further hypotension (which we definitely don't want!). However, the two goals in cardiogenic shock include enhancing effectiveness of the pump and decreasing demand on the pump. in looking at the other answer choices, they all have at least one part that does not meet those goals (A-negative inotrope, B-beta blocker, D-adenosine); but C does meet the treatment goals of cardiogenic shock. In real life, we would certainly use diuretics conservatively and make sure the patient can tolerate them. Hope that helps! :)
Ha same - was wrecking my brain trying to make sense of it. Also missed the one that asked which patient could benefit from antibiotics and didn’t even have septic shock run thru my mind lol
For question #14 the correct answer makes sense, but I did also want to ask this: COPD causes barrel chest and increased intrathoracic pressure decreases R heart filling. For this reason, I thought low CVP could have been the answer
I do see where you are coming from; great thought process! I'll have to look a little bit more into this but my idea constructing this question was focusing on the "chronic" emphysema/COPD, wherein over time, the pulmonary HTN is going to lead to R heart failure (constant backup of blood, elevated CVP)
If I find out a better pathophysiology answer, I will let you know!
Awesome lecture. Do you have a test bank that we can purchase or can you recommend one?
Unfortunately I do not have a test bank. I do recommend Barron's full tests (read the rationales!). I did get a 150-question test from AACN (I can't remember if it was free with the test purchase or because I also bought the AACN question bank) but I did like their 150-question test and rationales!
For question #11, I am confused because the treatment for it in your chart also says afterload reducers and when I look into what reduces afterload, it is nitrates reduce afterload. So, why isn’t the answer also B?
While nitrates may reduce afterload at higher dosages, they primarily reduce preload. IABP would be the best choice for this patient who is in cardiogenic shock!
Hi where can I find the lecture
ruclips.net/video/cweNLGwWdTw/видео.html :)