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.

Measure urinary output every hour.

Monitor serum potassium frequently.

Answer and Explanation

The Correct Answer is C

A. Assessing pupillary response to light is not directly related to the administration of dopamine for hypotension and does not reflect the immediate effects of the medication on the cardiovascular or renal systems.

B. Seizure precautions are not a standard intervention for a patient receiving dopamine unless the patient has a history of seizures or there is another indication for such precautions.

C. Measuring urinary output every hour is essential as it reflects the patient's fluid balance and kidney function, which can be affected by dopamine administration. It is a direct measure of the effectiveness of the medication in improving renal perfusion and the patient's hemodynamic status.

D. While monitoring serum potassium levels is important in patients receiving IV therapy, it is not the most immediate concern when administering dopamine for hypotension, unless the patient has a known electrolyte imbalance.

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Correct Answer is ["C","D","E","F","I","J"]

Explanation

A. Transfer to NICU - While NICU care is important, immediate stabilization takes precedence.

B. Keep in warmer with bilirubin lights - This is important for thermoregulation and managing jaundice but is not the most immediate concern.

C. Bolus of 2 ml/kg glucose 10% IV - This is critical to address the hypoglycemia (blood glucose 35 mg/dl).

D. Blood glucose level - Monitoring is essential for ongoing assessment of hypoglycemia.

E. Contact Respiratory Therapy for ABG and oxygen therapy - Given the high respiratory rate and potential for respiratory distress, this is a priority.

F. Feed immediately - Feeding can help stabilize blood glucose levels.

G. Apply dextrose (sugar) gel inside the baby's cheek - This is an alternative to IV glucose but less immediate than a bolus.

H. Echocardiogram - Important for cardiac assessment but not an immediate priority.

I. Monitor for respiratory distress - Essential due to the high respiratory rate and risk of complications from maternal diabetes.

J. Monitor temperature every 30 minutes - Important for detecting hypothermia due to the low axillary temperature.

A. Encourage rest until the analgesic becomes effective. B. Raise head of bed until to a 90 degree angle. C. Place bed in a reverse Trendelenburg position. D. Position bedside table so the client can lean across it.

Correct Answer is D

Explanation

Rationale for A: Encouraging rest might seem beneficial, but it does not address the immediate comfort need of the patient who is experiencing severe epigastric pain. Resting in a supine position may actually exacerbate the pain associated with pancreatitis.
Rationale for B: Raising the head of the bed to a 90-degree angle could potentially increase intra-abdominal pressure, which may worsen the pain for a patient with pancreatitis.
Rationale for C: The reverse Trendelenburg position is not typically indicated for pain relief in pancreatitis. This position might be used to promote gastric emptying or to alleviate respiratory distress, but not specifically for pancreatitis pain.
Rationale for D: Leaning forward can help decrease the pain in pancreatitis by reducing the tension on the peritoneal surfaces. Positioning a bedside table for the client to lean across can provide the necessary support for this position, which aligns with the recommendations for pain relief in pancreatitis.

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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

Patient data Exhibits The nurse is reviewing the orders for the infant of a diabetic mother to determine priorities Which 6 orders take priority?

Correct Answer is ["C","D","E","F","I","J"]

Explanation

A client with pancreatitis complains of severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

Correct Answer is D

Explanation

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