A nurse admits a patient awaiting surgery for an unstable pelvic fracture following a fall in which no other injuries were sustained. The nurse should prioritize
In the context of an unstable pelvic fracture, placing a binder across the patient's hips is crucial to stabilize the fracture and reduce the risk of further internal bleeding and damage. This intervention helps in temporarily stabilizing the pelvis until definitive surgical treatment can be performed. Transporting the patient for an MRI is not the immediate priority, as the primary goal is to stabilize the patient. Type and crossmatching PRBCs are important but should follow immediate stabilization measures. Administering a sedative to reduce movement can be considered, but it is not the top priority over physical stabilization of the fracture. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course
A patient with a left ventricular assist device has been hospitalized for 5 days. A nurse notes anasarca and skin breakdown over multiple pressure points. When addressing the patient's nutritional needs, which of the following should the nurse consider?


Protein calorie malnutrition (PCM) is a condition that occurs when the body does not get enough protein and calories to meet its needs. PCM can affect the immune system, wound healing, and organ function. Patients with a left ventricular assist device (LVAD) are at risk of PCM due to increased metabolic demands, fluid retention, inflammation, and poor appetite. Edema, or swelling, is a common sign of fluid overload in patients with LVADs. However, edema can also mask the physical signs of PCM, such as muscle wasting, weight loss, and skin changes. Therefore, the nurse should consider edema as a potential factor that can interfere with the assessment of the patient's nutritional status. Other methods to evaluate the patient's nutritional needs include laboratory tests, dietary intake, and body mass index. The nurse should also collaborate with a dietitian to provide appropriate nutritional interventions for the patient, such as oral supplements, enteral feeding, or parenteral nutrition.
Caring for patients with a left ventricular assist device, page 28.
Ventricular assist device (VAD) - Mayo Clinic, under ''Why it's done''.
Preoperative Nutritional Optimization and Physical Exercise for ..., under ''Introduction''.
Obesity in Patients with Advanced Heart Failure and Left Ventricular ..., under ''Introduction''.
The primary pathophysiology underlying acute respiratory failure in a patient with head trauma involves
In a patient with head trauma, the primary pathophysiology underlying acute respiratory failure often involves hypercapnia due to decreased minute ventilation. Head trauma can impair the central nervous system's ability to regulate breathing, leading to inadequate ventilation and a build-up of carbon dioxide (CO2) in the blood. Other factors like shifting of the oxyhemoglobin dissociation curve, increased intrapulmonary shunt, and dehydration due to diabetes insipidus may be present but are not the primary causes. Reference: CCRN Exam Handbook, AACN, page 25, section on Respiratory.
A patient with a spinal cord injury at T7 tells the nurse that they now have a pounding headache. The nurse should
A physician tries three times to insert a central line, then says, "I think I can get it this time." A nurse should
When a physician has attempted to insert a central line multiple times without success, the nurse's responsibility includes ensuring patient safety and advocating for the patient. Continued attempts by the same physician may increase the risk of complications, such as infection or trauma. Therefore, the nurse should suggest that another physician, possibly one with more experience or skill in central line insertion, perform the procedure. Reference: AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.
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