A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV infusion. The nurse should identify which of the following as an adverse effect of the medication and report to the provider?
Glasgow coma scale rating of 15
Crackles on auscultation
Increase in urinary output
Intracranial pressure reading of 12mm
The Correct Answer is B
A. Glasgow Coma Scale rating of 15: A Glasgow Coma Scale (GCS) rating of 15 is a positive sign indicating that the client is fully conscious and oriented. It is not an adverse effect of mannitol.
B. Crackles on auscultation: Crackles, also known as rales, can indicate fluid overload or pulmonary edema, which can be an adverse effect of mannitol. Mannitol can cause shifts of fluid, including into the lungs, leading to pulmonary edema.
C. Increase in urinary output: Mannitol is an osmotic diuretic, and an increase in urinary output is an expected and therapeutic effect of the medication. It is not considered an adverse effect.
D. Intracranial pressure reading of 12 mmHg: A decrease in intracranial pressure is a therapeutic effect of mannitol, and a reading of 12 mmHg is generally within a normal range. It is not considered an adverse effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Decrease in urine output:
This is the correct answer. Desmopressin is a synthetic form of antidiuretic hormone (ADH) that works to reduce urine output in individuals with diabetes insipidus. A decrease in urine output indicates a positive response to the medication.
B. Increase in serum glucose:
Desmopressin does not have a direct effect on serum glucose levels. Its primary action is to increase water reabsorption in the kidneys, reducing urine output.
C. Increase in WBC count:
Desmopressin does not have a direct impact on white blood cell (WBC) count. Its main action is on fluid balance and urine concentration.
D. Decrease in blood pressure:
Desmopressin can cause a mild increase in blood pressure, particularly at higher doses. However, blood pressure changes are not the primary therapeutic effect of desmopressin in the context of diabetes insipidus.
Correct Answer is D
Explanation
A. Dominant antecubital basilic vein:
While the basilic vein in the antecubital area is a suitable site, the nondominant arm is generally preferred when possible to minimize interference with the client's activities.
B. Nondominant dorsal venous arch:
The dorsal venous arch, located on the back of the hand or wrist, is a common site for peripheral IV catheter placement. It is preferred over other sites like the antecubital area due to lower risks of complications such as phlebitis and infiltration. Additionally, using the nondominant hand reduces interference with daily activities.
C. Dominant distal dorsal vein:
The dorsal veins are generally not the first choice for peripheral IV catheter placement due to the potential for complications such as infiltration.
D. Nondominant forearm basilic vein:
Nondominant forearm basilic vein: The basilic vein in the nondominant forearm is often a suitable site for peripheral IV catheter placement. The nondominant arm is preferred when feasible to minimize disruption of activities for the client. However, its preferred to start the IV infusion distally to provide the option of proceeding up the extremity if the vein is ruptured or infiltration occurs; if infiltration occurs from the antecubital vein, the lower veins in the same arm usually should not be used for further puncture sites.
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