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 B
Explanation
A) Lactated Ringer's: Lactated Ringer's solution is not app’opriate in this si’uation because it does not provide the necessary nutrients found in TPN. It is primarily used for fluid replacement and maintenance and does not contain the essential macronutrients required for TPN.
B) Dextrose 10% in water: This is the correct fluid to administer when the current bag of TPN has finished infusing and the next bag is not yet available. Dextrose 10% in water provides a source of glucose, which can help prevent hypoglycemia in clients dependent on TPN. While it does not provide the full spectrum of nutrients found in TPN, it can temporarily meet the client's caloric needs until the next bag of TP’ becomes available.
C) 0.45% sodium chloride: This solution, also known as half-normal saline, is hypotonic and primarily used for hydration and maintenance fluids. It does not provide adequate nutrition and is not a suitable substitute for TPN.
D) 0.9% sodium chloride: This solution, also known as normal saline, is isotonic and used for fluid resuscitation, maintenance, and replacement. Like 0.45% sodium chloride, it does not contain the necessary nutrients for TPN and is not appropriate as a substitute.
Correct Answer is A
Explanation
A) Hypertension: Phenelzine is a monoamine oxidase inhibitor (MAOI) used as an antidepressant medication. It works by inhibiting the breakdown of neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. When phenelzine is taken with foods high in tyramine, such as aged cheese, a potentially dangerous interaction can occur. Tyramine-rich foods can cause the release of stored catecholamines, leading to a sudden increase in blood pressure, known as a hypertensive crisis. Symptoms of a hypertensive crisis can include severe headache, palpitations, chest pain, nausea, vomiting, and sweating. Therefore, hypertension is a manifestation of the interaction between phenelzine and aged cheese.
B) Bradycardia: Bradycardia, or slow heart rate, is not typically associated with the interaction between phenelzine and aged cheese. Instead, the interaction is more commonly associated with a sudden increase in blood pressure (hypertension).
C) Somnolence: Somnolence, or drowsiness, is a common side effect of phenelzine but is not specifically related to the interaction between phenelzine and aged cheese.
D) Diarrhea: Diarrhea is not typically associated with the interaction between phenelzine and aged cheese. Instead, the interaction is more commonly associated with a sudden increase in blood pressure (hypertension).
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