A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective?
Increased urine output
Decreased blood glucose level
Decreased blood pressure
Increased heart rate
The Correct Answer is A
Choice A Reason: Dobutamine is a positive inotropic agent that increases the contractility of the heart and improves cardiac output. This leads to increased renal perfusion and urine output, which reduces the fluid overload and edema associated with heart failure. Therefore, this choice is correct.
Choice B Reason: Dobutamine does not have a direct effect on blood glucose level. It may cause hyperglycemia as a side effect, but this is not an indication of its effectiveness. Therefore, this choice is incorrect.
Choice C Reason: Dobutamine may cause a slight decrease in blood pressure due to vasodilation, but this is not its main therapeutic effect. A significant decrease in blood pressure may indicate hypovolemia, hypotension, or shock, which are adverse effects of dobutamine. Therefore, this choice is incorrect.
Choice D Reason: Dobutamine also has a positive chronotropic effect, which means it increases the heart rate. However, this is not a desired outcome for a client with heart failure, as it increases the oxygen demand of the heart and may worsen the condition. Therefore, this choice is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: Preventing musculoskeletal disability is important, but not the priority focus of care. The nurse should first assess and manage the client's life-threatening injuries, such as airway obstruction, bleeding, shock, or brain injury.
Choice B Reason: Airway protection is the priority focus of care for a client with multiple system trauma. The nurse should ensure that the client has a patent airway and adequate ventilation, as any compromise in these areas can quickly lead to hypoxia, respiratory failure, and death.
Choice C Reason: Stabilizing cardiac arrhythmias is also important, but not the priority focus of care. The nurse should monitor the client's cardiac rhythm and treat any arrhythmias that may occur, but only after securing the airway and breathing.
Choice D Reason: Decreasing intracranial pressure is another important goal, but not the priority focus of care. The nurse should assess the client's neurological status and intervene to prevent or reduce increased intracranial pressure, such as elevating the head of the bed, maintaining normothermia, and administering osmotic diuretics. However, these measures are secondary to ensuring adequate oxygenation and perfusion.
Correct Answer is A
Explanation
Choice A Reason: This is correct because an osmotic diuretic, such as mannitol, works by creating an osmotic gradient that draws fluid from the brain tissue into the blood vessels, thereby reducing cerebral edema and intracranial pressure.
Choice B Reason: This is incorrect because an osmotic diuretic would decrease, not increase, the cell size in the brain by removing fluid from the intracellular space.
Choice C Reason: This is incorrect because an osmotic diuretic would decrease, not expand, the extracellular fluid volume by increasing the urine output and excreting excess fluid from the body.
Choice D Reason: This is incorrect because an osmotic diuretic would not provide fluid hydration, but rather cause fluid loss and dehydration.
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