A client who is hypotensive is receiving dopamine, an adrenergic agonist, IV at the rate of 8 mcg/kg/min. Which intervention should the nurse implement while administering this medication?

Assess pupillary response to light hourly.

Initiate seizure precautions.

Monitor serum potassium frequently.

Measure urinary output every hour.

Answer and Explanation

The Correct Answer is D

A. Assess pupillary response to light hourly: Dopamine administration may cause changes in pupillary response, but it is not the primary concern associated with its administration. Hourly pupillary assessment may not be necessary unless other signs of neurological changes are present.

B. Initiate seizure precautions: While dopamine administration may cause neurological effects, such as agitation or tremors, it is not typically associated with seizure activity. Seizure precautions are not indicated solely due to dopamine infusion.

C. Monitor serum potassium frequently: Dopamine administration can affect potassium levels, but monitoring serum potassium levels frequently may not be necessary unless the client has pre- existing potassium imbalances or is at risk for electrolyte disturbances.

D. Measure urinary output every hour: Dopamine is a vasopressor medication that can increase blood pressure and cardiac output, potentially leading to increased renal perfusion and urinary output. Monitoring urinary output hourly is essential to assess the client's response to dopamine therapy and ensure adequate renal function.

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Correct Answer is C

Explanation

A. Blood alcohol level of 0.09% (90 mmol/L): Although an elevated blood alcohol level could contribute to slurred speech and unsteady gait, the client's clinical presentation is more consistent with lithium toxicity rather than alcohol intoxication. However, it's important to assess for recent alcohol consumption and potential interactions with medications.

B. Six hours of sleep in the past three days: Sleep disturbances are common in bipolar disorder, but in this scenario, the more concerning issue is the potential lithium toxicity, as indicated by the client's symptoms.

C. Serum lithium level of 1.6 mEq/L (1.6 mmol/L): Correct! A serum lithium level above the therapeutic range (greater than 1.2 mEq/L) can lead to adverse effects such as slurred speech, ataxia, and tremors. This finding indicates lithium toxicity and requires immediate intervention.

D. Weight loss of 10 pounds (4.5 kg) in past month: Weight changes can be a concern in bipolar disorder, but in this case, the symptoms are more suggestive of lithium toxicity rather than related to weight loss

A. Provide disposable training pants while calming the mother. B. Refer the mother to a community parent education program. C. Suggest that the mother consult a pediatric nephrologist. D. Inform the mother that toilet training is slower for boys.

Correct Answer is A

Explanation

A. Provide disposable training pants while calming the mother: This option addresses the

immediate need to provide comfort and support to the child and mother. Offering disposable

training pants can help manage the situation while the nurse addresses the mother's distress and educates her about age-appropriate toilet training expectations.

B. Refer the mother to a community parent education program: While parent education programs can be beneficial, they are not the initial action needed in this situation, which requires
immediate intervention to support the child and mother.
C. Suggest that the mother consult a pediatric nephrologist: Referring the mother to a pediatric nephrologist may not be necessary at this point, as wetting accidents are common in young
children during the toilet training process. The nurse should first address the immediate emotional needs of the child and mother.
D. Inform the mother that toilet training is slower for boys: While it's true that toilet training can vary in timing for different children, simply providing this information to the mother may not be sufficient in addressing the distressing situation at hand.

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A client who is hypotensive is receiving dopamine, an adrenergic agonist, IV at the rate of 8 mcg/kg/min. Which intervention should the nurse implement while administering this medication?

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Correct Answer is C

Explanation

The nurse on a pediatric unit observes a distraught mother in the hallway scolding her 3-year- old son for wetting his pants. What initial action should the nurse take?

Correct Answer is A

Explanation

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