A nurse is preparing to titrate a continuous nitroprusside infusion for a client. The nurse should plan to titrate the infusion according to which of the following assessments?
Stroke volume
Cardiac output
Urine output
Blood pressure
The Correct Answer is D
A) Stroke volume: Stroke volume is the amount of blood ejected from the heart with each contraction, and it's an essential parameter in assessing cardiac function. However, when titrating a nitroprusside infusion, the primary goal is to manage blood pressure rather than directly targeting stroke volume. Nitroprusside is primarily used as a vasodilator to lower blood pressure in hypertensive emergencies. While changes in blood pressure may indirectly affect stroke volume, blood pressure itself is the primary parameter for titration.
B) Cardiac output: Cardiac output, which is the volume of blood pumped by the heart per minute, may be affected by nitroprusside due to its vasodilatory effects. However, like stroke volume, cardiac output is not typically the primary parameter for titrating a nitroprusside infusion. Blood pressure is a more direct indicator of the drug's effect on vascular tone and perfusion pressure.
C) Urine output: Monitoring urine output is crucial for assessing renal function and fluid status, but it is not the primary parameter used to titrate a nitroprusside infusion. While nitroprusside may affect renal blood flow and urine output indirectly, blood pressure remains the immediate indicator of the drug's hemodynamic effects.
D) Blood pressure: Nitroprusside is a potent vasodilator commonly used to lower blood pressure in hypertensive emergencies. Therefore, the primary assessment parameter for titrating a nitroprusside infusion is blood pressure. The nurse should monitor the client's blood pressure frequently and adjust the infusion rate accordingly to achieve the desired therapeutic effect while avoiding hypotension or excessive lowering of blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) WBC count: Filgrastim is a granulocyte colony-stimulating factor (G-CSF) medication used to stimulate the production of white blood cells (WBCs), particularly neutrophils, in individuals with neutropenia. Therefore, monitoring the WBC count is essential to evaluate the effectiveness of filgrastim therapy. An increase in WBC count indicates a response to treatment, helping to prevent or manage neutropenic complications such as infections.
B) INR: The international normalized ratio (INR) is a laboratory test used to monitor the effectiveness of anticoagulant therapy, particularly warfarin (Coumadin). It measures the clotting ability of the blood and is not directly related to filgrastim therapy. Therefore, monitoring the INR is not appropriate for evaluating the effectiveness of filgrastim treatment.
C) BUN: Blood urea nitrogen (BUN) is a laboratory test used to assess kidney function and hydration status. It measures the concentration of urea nitrogen in the blood and is not directly related to filgrastim therapy. Monitoring BUN levels may be indicated for assessing renal function in certain clinical contexts but is not specific to evaluating the effectiveness of filgrastim treatment.
D) Potassium level: Monitoring potassium levels is important for assessing electrolyte balance and kidney function but is not directly related to filgrastim therapy. Potassium levels may be affected by various factors, including medications, diet, and renal function. However, they do not directly reflect the effectiveness of filgrastim in stimulating WBC production.
Correct Answer is A
Explanation
A) Grasp skin between thumb and forefinger throughout the injection: This is the correct answer. Grasping the skin between the thumb and forefinger creates tension, which helps to stabilize the tissue during the injection. This technique reduces the risk of tissue damage and minimizes bleeding following the injection of heparin subcutaneously.
B) Aspirate the syringe prior to injecting the heparin: Aspiration is not necessary for subcutaneous injections, as the risk of intravascular injection is minimal. Aspirating the syringe can increase discomfort for the client and is not recommended for subcutaneous injections.
C) Use the Z-track method to administer the medication: The Z-track method is used for intramuscular injections to minimize medication leakage into the subcutaneous tissue. However, heparin is typically administered subcutaneously, and the Z-track method is not appropriate for this route of administration.
D) Gently massage the site following the injection: Massaging the site following a subcutaneous injection of heparin can increase the risk of bleeding and hematoma formation. Therefore, this action should be avoided to minimize bleeding at the injection site.
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