After administering an inotropic medication to a patient in shock, the nurse monitors the patient for signs of:

Decreased cardiac output.

Increased afterload.

Increased cardiac output.

Slowing of the heart rate.

Answer and Explanation

The Correct Answer is C

A. Decreased cardiac output: Inotropic medications are intended to improve cardiac function and increase cardiac output, so monitoring for signs of decreased cardiac output would be contrary to the expected therapeutic effect of these medications.

B. Increased afterload: Inotropic medications primarily affect the contractility of the heart muscle and do not typically have a direct effect on afterload (the force against which the heart must pump blood). While changes in afterload can occur as a secondary consequence of altered cardiac function, monitoring for signs of increased afterload would not be the primary focus after administering an inotropic medication.

C. Increased cardiac output.
Inotropic medications are drugs that affect the contractility of the heart muscle. They are often used in the management of shock to improve cardiac function and increase cardiac output. Therefore, after administering an inotropic medication, the nurse would monitor the patient for signs of increased cardiac output, such as improved peripheral perfusion, increased blood pressure, and resolution of signs and symptoms of shock.

D. Slowing of the heart rate: Inotropic medications can affect heart rate indirectly by altering cardiac output, but their primary effect is on contractility rather than heart rate. Monitoring for signs of bradycardia (slowing of the heart rate) may be appropriate in certain clinical situations, but it is not the primary consideration after administering an inotropic medication for shock.

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Correct Answer is D

Explanation

A) Low-back pain:
Low-back pain is not a common manifestation of an allergic reaction to a blood transfusion. It may be associated with other conditions, such as musculoskeletal issues or renal complications, but it is not typically addressed by diphenhydramine administration during transfusion.

B) Fever:
While fever can occur as a manifestation of an adverse reaction to a blood transfusion, it is more commonly associated with non-allergic transfusion reactions such as transfusion-related acute lung injury (TRALI) or bacterial contamination of the blood product. Diphenhydramine is not specifically indicated for the prevention of fever during transfusion.

C) Dyspnea:
Dyspnea, or difficulty breathing, can occur as a manifestation of a severe allergic reaction or anaphylaxis during a blood transfusion. However, diphenhydramine alone may not be sufficient to prevent or treat severe respiratory symptoms associated with anaphylaxis. In such cases, prompt medical intervention and administration of epinephrine may be necessary. Diphenhydramine primarily targets histamine-mediated symptoms such as urticaria and itching.

D) Urticaria.
Urticaria, commonly known as hives, is a skin reaction characterized by raised, itchy welts that can occur as a result of an allergic or hypersensitivity reaction. During a blood transfusion, if the recipient's immune system reacts to foreign proteins in the transfused blood, it can lead to an allergic reaction characterized by symptoms such as urticaria, itching, flushing, and sometimes more severe reactions like anaphylaxis.
Diphenhydramine is an antihistamine medication that works by blocking the effects of histamine, a chemical released by the body during allergic reactions. By administering diphenhydramine before the blood transfusion, the nurse aims to prevent or minimize the occurrence of urticaria and other allergic symptoms.

A. Theophylline B. Montelukast C. Albuterol D. Salmeterol

Correct Answer is C

Explanation

A) Theophylline:
Theophylline is a bronchodilator medication that is used for the long-term management of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol.

B) Montelukast:
Montelukast is a leukotriene receptor antagonist that is used for the long-term management of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol.

C) Albuterol.
The patient is presenting with symptoms consistent with an asthma exacerbation, including shortness of breath, increased work of breathing, expiratory wheezing, and a history of asthma. Albuterol is a short-acting beta agonist bronchodilator commonly used as the first-line treatment for acute asthma exacerbations. It acts quickly to relax bronchial smooth muscles, relieve bronchoconstriction, and improve airflow, which can help alleviate the patient's symptoms of shortness of breath and wheezing.

D) Salmeterol:
Salmeterol is a long-acting beta agonist bronchodilator that is used for the maintenance treatment of asthma, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta agonists like albuterol, and it is not recommended for rapid relief of acute symptoms.

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After administering an inotropic medication to a patient in shock, the nurse monitors the patient for signs of:

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose of diphenhydramine is to prevent which of the following manifestations of a transfusion reaction?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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