I don't understand this multiple choice question.

Early goal directed therapy is for the aggressive treatment of septic shock that involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand as measured by:

CVP between 8-12 mmHg

MAP between 65 - 90 mmHg

SVO2 >= 70%

.

Are you at student nurse or an RN in a BSN completion program?

I'm currently in an RN program.

I'm a student completing my RN program*

Are you at student nurse or an RN in a BSN completion program?

Man, those titles just keep adding on to your name, huh. Very cool.

I think she's inquiring because you are using the word "nurse" in your user name, which is against TOS if you are currently a student with no nursing license.

Man, those titles just keep adding on to your name, huh. Very cool.

I think she's inquiring because you are using the word "nurse" in your user name, which is against TOS if you are currently a student with no nursing license.

Perhaps Alpha is an LPN completing an RN program.

I doubt it, just being a maverick. Alpha Male in a user name is telling you something, though.

The topic is Shock and multisystem failure

Question: In early goal-directed therapy, the nurse knows that which of the following parameters are monitored in evaluating effectiveness of therapy?

A.) HR and BP

B.) SVO2 and O2 saturation

C.) Base deficit and hematocrit

D. SvO2 and CVP

I read through the chapter twice, but I don't think I understand the question. My gut is telling me A.) because it's the most simple answer, and it makes sense when it comes to shock.

Why is shock bad? Because tissues are starved of oxygen and means to achieve homeostasis.

Now reconsider your answer. If still unclear, ask me to expand on this. If you've really read the chapter twice, try it again with this in mind.

The answer is D.

Now you tell me why and what SvO2 and CVP are.

Man, those titles just keep adding on to your name, huh. Very cool.

OH, I like your new name, Very Clever, Grasshopper. Take Care. You too can go on and add more alphabet soup to your name. One at a time.

The answer is D.

Now you tell me why and what SvO2 and CVP are.

Well, CVP is central venous pressure. And it's used to help monitor the patient's response to fluid resuscitation (fluid resuscitation is the first line of treatment for shock then vasoactive meds). The value is normally 2 to 8 mm Hg, but we want higher than normal CVPs readings in shock, since ventricles tend to stiffen during shock. So assessment of SVO2 with a CVP line is helpful in evaluating the adequacy of intravascular volume.

And O2 saturation isn't going to help us for shock.

What is SvO2 and what does it tell us about a patient in shock?

The

Well, CVP is central venous pressure. And it's used to help monitor the patient's response to fluid resuscitation (fluid resuscitation is the first line of treatment for shock then vasoactive meds). The value is normally 2 to 8 mm Hg, but we want higher than normal CVPs readings in shock, since ventricles tend to stiffen during shock. So assessment of SVO2 with a CVP line is helpful in evaluating the adequacy of intravascular volume.

And O2 saturation isn't going to help us for shock.

The question is asking about "goal directed therapy." Your goal in treating shock is to provide adequate tissue oxygenation. Therefore, what two measurements tell you about tissue oxygenation? CVP tells you about volume, an important concept in delivery capability. SVO2 tells you how much oxygen there is left in the blood after the arterial side has done its best to deliver it. O2 sat tells you how much oxygen was out there for the taking (remember to look at hematocrit for the complete picture there-- a 99% sat with a crit of 15 delivers only one third the amount of oxygen that a 99% sat of a crit of 45 delivers). Therefore in my opinion, O2 sat and SVO2 are the parameters that tell you the most about your goal, oxygen delivery and tissue uptake.