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. When the client has ankle edema Ankle edema may indicate fluid retention, which is common during pregnancy but is not directly related to the assessment of deep tendon reflexes (DTRs).

B. Within the first trimester of pregnancy: Assessing DTRs within the first trimester of pregnancy is not specifically indicated unless there are other signs or symptoms of concern.

C. If the client has an elevated blood pressure: Assessment of DTRs is particularly important if the client has an elevated blood pressure, as it may indicate preeclampsia, a serious pregnancy complication characterized by hypertension and proteinuria.

D. During admission to labor and delivery: While assessment of DTRs may be included in the admission assessment to labor and delivery, it is particularly important to assess DTRs if the client has an elevated blood pressure, as it may indicate preeclampsia.

A. Secure chest tube to the stretcher for transport. B. Mark the amount of chest drainage on the container. C. Keep the chest tube container below the site of insertion. D. Administer PRN pain medication prior to transport

Correct Answer is C

Explanation

A. Secure chest tube to the stretcher for transport: While securing the chest tube is important to prevent dislodgement during transport, the priority is to ensure proper drainage and prevent air leaks by keeping the chest tube container below the site of insertion.
B. Mark the amount of chest drainage on the container: While it's important to document chest drainage, ensuring proper drainage by keeping the container below the insertion site takes precedence, especially during transport.
C. Keep the chest tube container below the site of insertion: Correct! Keeping the chest tube
container below the site of insertion ensures continuous drainage of air and fluid from the pleural space, which is crucial for maintaining respiratory function and preventing complications such as pneumothorax.
D. Administer PRN pain medication prior to transport: Pain management is important, but in this urgent situation, maintaining proper chest tube function and respiratory support is the priority.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When is it most important for the nurse to assess a pregnant client's deep tendon reflexes (DTRs)?

Correct Answer is C

Explanation

A client is being urgently transported to radiology for a Computerized Tomography (CT scan) after a sudden decrease in the level of consciousness. The client is orally intubated and has a left lateral chest tube to 20 cm suction. Which action is most important for the nurse to take?

Correct Answer is C

Explanation

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