A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client is responding to the treatment?

A) Extravasation: Extravasation, or the leaking of IV medication into surrounding tissues, is a potential complication of IV therapy. However, it does not indicate a need to increase the rate of dopamine infusion. Instead, the priority is to stop the infusion, assess the site for damage, and provide appropriate interventions to minimize tissue injury.

B) Hypotension: Hypotension, or low blood pressure, is a common indication for administering dopamine in septic shock to improve cardiac output and increase blood pressure. If the client's blood pressure remains low despite the’current rate of dopamine infusion, it may be necessary to increase the infusion rate to achieve the desired therapeutic effect and improve perfusion to vital organs. Therefore, hypotension is the correct finding that indicates the need to increase the rate of infusion.

C) Headache: While headache can occur as a side effect of dopamine infusion, it is not typically an indication to increase the infusion rate. Headache may warrant further assessment and management, but it does not directly correlate with the need for a higher dose of dopamine.

D) Chest pain: Chest pain may occur as a side effect of dopamine infusion or could be indicative of other cardiac or pulmonary issues. However, like headache, it is not a specific indicator for increasing the rate of dopamine infusion. Further assessment and appropriate interventions are needed to address chest pain, but it does not directly relate to the need for a higher infusion rate of dopamine.

A) Discontinue the infusion: While discontinuing the parenteral nutrition infusion may be necessary in severe cases of hypoglycemia, it should not be the initial action unless the client's condition warrants it. Discontinuing the infusion without providing alternative sources of glucose may exacerbate the hypoglycemia and lead to further complications.

B) Obtain arterial blood gases: Arterial blood gases (ABGs) are not typically indicated for evaluating hypoglycemia. While ABGs provide valuable information about acid-base balance and oxygenation status, they do not directly assess blood glucose levels or contribute to the management of hypoglycemia.

C) Warm formula to room temperature: Warming the parenteral nutrition formula to room temperature may improve comfort during administration, but it is not directly related to managing hypoglycemia. Hypoglycemia requires prompt intervention to raise blood sugar levels, and warming the formula would not address the immediate need for glucose supplementation.

D) Administer IV dextrose: Hypoglycemia is a potentially serious complication of parenteral nutrition administration, especially if the infusion rate is too high or if the client's metabolic needs are not adequately met. IV dextrose, a concentrated glucose solution, is the most appropriate intervention for treating hypoglycemia in this situation. It provides a rapid source of glucose to raise blood sugar levels quickly and effectively.