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: This is incorrect because the laboratory values are not within the expected reference range in a client who has DIC. DIC is a condition that causes abnormal activation of the clotting cascade, leading to widespread microthrombi formation and consumption of clotting factors and platelets. This results in bleeding complications and organ dysfunction.
Choice B Reason: This is correct because the laboratory values are prolonged in a client who has DIC. PT, aPTT, and INR are tests that measure the time it takes for blood to clot. PT measures the extrinsic pathway, aPTT measures the intrinsic pathway, and INR is a standardized ratio of PT. In DIC, these tests are prolonged because of the depletion of clotting factors and platelets.
Choice C Reason: This is incorrect because the laboratory values are not the same as the previous test values in a client who has DIC. DIC is an acute and dynamic condition that can change rapidly depending on the underlying cause and treatment. The laboratory values may fluctuate between normal, prolonged, or shortened depending on the balance between clotting and bleeding.
Choice D Reason: This is incorrect because the laboratory values are not decreased in a client who has DIC. Decreased laboratory values would indicate a shortened clotting time, which can occur in some cases of DIC when there is excessive clotting and thrombosis. However, this is not the typical finding in DIC, as most clients present with bleeding manifestations and prolonged clotting time.
Correct Answer is A
Explanation
Choice A Reason: This is correct because dopamine is a vasopressor that increases the contractility and stroke volume of the heart, which results in an increased systolic blood pressure.
Choice B Reason: This is incorrect because dopamine can cause tachycardia as a side effect, but this does not indicate a therapeutic effect. An increased radial heart rate can also indicate other conditions, such as anxiety, fever, or dehydration.
Choice C Reason: This is incorrect because dopamine does not reduce cardiac output, but rather increases it by improving the pumping function of the heart.
Choice D Reason: This is incorrect because dopamine does not reduce urine output, but rather increases it by stimulating the renal blood vessels and enhancing renal perfusion.
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