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You Are Caring for a Critically Ill Patient Whose Urine

question 24

Multiple Choice

You are caring for a critically ill patient whose urine output has been low for 2 consecutive hours.After a thorough patient assessment,you call the intensivist with the following report.Dr.Smith,I'm calling about Mrs.P.,your 65-year-old patient in CCU 10.Her urine output for the past 2 hours totaled only 40 mL.She arrived from surgery to repair an aortic aneurysm 4 hours ago and remains on mechanical ventilation.In the past 2 hours,her heart rate has increased from 80 to 100 beats per minute and her blood pressure has decreased from 128/82 to 100/70 mm Hg.She is being given an infusion of normal saline at 100 mL per hour.Her right atrial pressure through the subclavian central line is low at 3 mm Hg.Her urine is concentrated.Her BUN and creatinine levels have been stable and in normal range.Her abdominal dressing is dry with no indication of bleeding.My assessment suggests that Mrs.P.is hypovolemic and I would like you to consider increasing her fluids or giving her a fluid challenge.Using the SBAR model for communication,the information the nurse gives about the patient's history and vital signs is:

Definitions:

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