A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?
The client tolerates a second dose of medication with no greater than 1 peripheral edema.
Respirations are unlabored.
Client reports decreased groin pain of 3 on a 1 to 10 scale.
The client's blood pressure when arising from resting position is at premedication levels.
The Correct Answer is B
A) The client tolerates a second dose of medication with no greater than 1 peripheral edema:
This does not directly indicate a therapeutic response to epinephrine for angioedema. Angioedema primarily involves swelling of deeper layers of the skin, often around the eyes and lips, and sometimes the throat, which can cause breathing difficulties. Tolerating a second dose of medication with minimal peripheral edema does not specifically address the acute respiratory effects of angioedema.
B) Respirations are unlabored:
This is the correct answer. Angioedema can cause swelling in the airways, leading to difficulty breathing. Epinephrine is used to reduce this swelling and improve airway patency. Unlabored respirations indicate that the airway is not obstructed, which means the epinephrine has successfully alleviated the swelling causing the angioedema.
C) Client reports decreased groin pain of 3 on a 1 to 10 scale:
Decreased groin pain is not relevant to the treatment of angioedema with epinephrine. Pain relief in the groin area does not indicate a therapeutic response to epinephrine, which is primarily used to address airway and anaphylactic symptoms.
D) The client's blood pressure when arising from resting position is at premedication levels:
While epinephrine can affect blood pressure, the main concern with angioedema is airway obstruction rather than blood pressure control. Normalizing blood pressure does not specifically indicate that the epinephrine has successfully treated the angioedema and improved the client's respiratory status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
Answer: A, C, D, E
Rationale:
A) Yoga: Yoga is an effective nonpharmacological therapy that combines physical postures, breathing exercises, and meditation, which can help reduce stress, improve flexibility, and enhance mental focus.
B) Electromagnetic therapy: Electromagnetic therapy is typically used for pain management or to promote wound healing rather than stress reduction. It is not commonly included in stress management techniques.
C) Meditation: Meditation focuses on mindful breathing and awareness, which can significantly reduce stress by calming the mind and improving emotional resilience. It’s widely used to help manage stress and anxiety.
D) Acupuncture: Acupuncture involves the insertion of needles at specific body points and is believed to release endorphins and balance energy flow, which can reduce stress and promote relaxation.
E) Biofeedback: Biofeedback teaches clients to control physiological responses like heart rate and muscle tension, helping them manage stress and anxiety effectively through self-regulation techniques.
Correct Answer is D
Explanation
A. Light-headedness when standing up:
Elevated potassium levels (hyperkalemia) can lead to muscle weakness or paralysis, cardiac dysrhythmias, and even cardiac arrest. Light-headedness when standing up is more commonly associated with orthostatic hypotension or volume depletion rather than electrolyte imbalances like hyperkalemia.
B. Weak quadriceps muscles:
Weakness in the quadriceps muscles is not typically associated with the electrolyte imbalances presented in the scenario. Hyperkalemia can cause muscle weakness, but it is not specific to the quadriceps.
C. Decreased deep tendon reflexes:
Decreased deep tendon reflexes are not typically associated with the electrolyte imbalances presented in the scenario. Hyperkalemia can lead to hyperreflexia or absent reflexes, but it is not specific to decreased deep tendon reflexes.
D. Tingling of extremities:
This is the correct answer. Hypocalcemia, indicated by the low calcium level in the scenario, can manifest with symptoms such as tingling or numbness of the extremities, muscle cramps, and tetany. Calcium plays a crucial role in nerve transmission, and low levels can lead to sensory disturbances like tingling in the extremities.
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