A nurse is caring for a client who is experiencing Cushing's triad following a subdural hematoma. Which of the following medications should the nurse plan to administer?

Albumin 25%

Dextran 70

Mannitol 25%

Hydroxyethyl starch

Answer and Explanation

The Correct Answer is C

Choice A Reason: Albumin 25% is not a medication that the nurse should plan to administer for a client who is experiencing Cushing's triad following a subdural hematoma. Albumin 25% is a colloid solution that increases the oncotic pressure and draws ﬂuid from the interstitial space into the intravascular space, which can worsen the intracranial pressure by increasing the cerebral blood ﬂow and edema.

Choice B Reason: Dextran 70 is not a medication that the nurse should plan to administer for a client who is experiencing Cushing's triad following a subdural hematoma. Dextran 70 is a plasma expander that increases the blood volume and viscosity, which can also worsen the intracranial pressure by increasing the cerebral blood ﬂow and edema.

Choice C Reason: Mannitol 25% is a medication that the nurse should plan to administer for a client who is experiencing Cushing's triad following a subdural hematoma. Mannitol 25% is an osmotic diuretic that reduces the intracranial pressure by creating an osmotic gradient and drawing ﬂuid from the brain tissue into the blood vessels, which can then be excreted by the kidneys. The nurse should monitor the urine output, serum osmolality, and electrolytes when administering mannitol 25%.

Choice D Reason: Hydroxyethyl starch is not a medication that the nurse should plan to administer for a client who is experiencing Cushing's triad following a subdural hematoma. Hydroxyethyl starch is another plasma expander that has similar eﬀects as dextran 70, and can also increase the risk of coagulopathy and renal failure.

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Correct Answer is C

Explanation

Choice A Reason: This is incorrect because hypervolemia is a condition of excess ﬂuid volume in the body. A client who has an extensive burn injury is more likely to have hypovolemia, which is a condition of low ﬂuid volume, due to ﬂuid loss from the damaged skin and capillaries.

Choice B Reason: This is incorrect because metabolic alkalosis is a condition of high blood pH and high bicarbonate level. A client who has an extensive burn injury is more likely to have metabolic acidosis, which is a condition of low blood pH and low bicarbonate level, due to increased production of lactic acid and ketones from tissue hypoxia and breakdown.

Choice C Reason: This is correct because low hemoglobin is a common laboratory finding in a client who has an extensive burn injury. Hemoglobin is the protein in red blood cells that carries oxygen. A client who has an extensive burn injury may have low hemoglobin due to hemolysis, which is the destruction of red blood cells, or hemorrhage, which is the loss of blood.

Choice D Reason: This is incorrect because hyperkalemia is a condition of high blood potassium level. A client who has an extensive burn injury may have hyperkalemia in the early phase of injury, due to cell damage and potassium release, but it is usually transient and followed by hypokalemia, which is a condition of low blood potassium level, due to ﬂuid loss and potassium depletion.

A. Increased urine output B. Decreased blood glucose level C. Decreased blood pressure D. Increased heart rate

Correct Answer is A

Explanation

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.

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A nurse is caring for a client who is experiencing Cushing's triad following a subdural hematoma. Which of the following medications should the nurse plan to administer?

Nursing Test Bank

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