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 A

Explanation

A. Determining the client's need for pain medication is a priority to ensure comfort and manage symptoms as the client approaches end of life.
B. Updating the nurse manager on the client's status is important, but it is not the priority action in terms of direct client care.
C. Conveying the client's status to the chaplain may be part of holistic care, but the immediate physical needs of the client take precedence.
D. Documenting the impending signs of death is essential for medical records, but addressing the client's comfort needs is the priority.

A. Notify the healthcare provider. B. Prepare a continuous heparin infusion per protocol. C. Provide supplemental oxygen. D. Bring the emergency crash cart to the bedside.

Correct Answer is C

Explanation

A. While notifying the healthcare provider is important, the priority is to address the client's immediate physiological needs.
B. Starting a continuous heparin infusion is important in the management of a pulmonary embolus, but providing oxygen is the first priority to ensure adequate oxygenation.

C. Providing supplemental oxygen helps alleviate hypoxia, which is critical in the management of a pulmonary embolus.
D. Bringing the emergency crash cart may be necessary if the client's condition deteriorates, but providing oxygen takes precedence in the initial management.

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