Norepinephrine has been prescribed for a patient who was admitted with dehydration and hypotension. Which data indicate that the nurse should consult with the health care provider before starting the norepinephrine?
The patient's central venous pressure is 3 mm Hg.
The patient is receiving low dose dopamine.
The patient is in sinus tachycardia at 120 beats/min.
The patient has had no urine output since admission.
The Correct Answer is A
A Adequate fluid administration is essential before giving vasopressors to patients with hypovolemic shock. The patient’s low central venous pressure indicates a need for more volume replacement. The other patient data are not contraindications to norepinephrine administration.
B Low dose dopamine is not a contraindication to epinephrine administration.
C A sinus tachycardia is not a contraindication to epinephrine administration
D Lack of urine output is not a contraindication to epinephrine administration
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Prone positioning involves turning the patient onto their abdomen to improve ventilation-perfusion matching by redistributing ventilation to the dorsal lung regions, where perfusion is typically better in ARDS patients.
B. Semi-recumbent positioning may be used to prevent aspiration and reduce the risk of VAP but is not as effective as prone positioning for improving V/Q matching.
C. Albumin infusion is not specific interventions for improving ventilation-perfusion matching in ARDS and should be considered based on other clinical indications.
D. Transfusion of packed red blood cells (PRBC) may be indicated in cases of severe anemia or hypoxemia due to inadequate oxygen-carrying capacity. However, it is not a primary intervention for improving ventilation-perfusion matching in ARDS
Correct Answer is B
Explanation
B. Assessing the client's vital signs, including blood pressure and pulse, provides critical information about the client's hemodynamic status and response to the new rhythm. Atrial fibrillation can lead to rapid, irregular heart rates and hemodynamic instability, so obtaining vital signs promptly helps the nurse determine the severity of the situation and whether immediate intervention is needed.
A. This action is not the priority when the nurse observes a new onset of atrial fibrillation. While beta- blockers such as metoprolol may be part of the client's long-term management for heart failure and atrial fibrillation, initiating medication administration without further assessment could delay appropriate intervention for the acute change in rhythm.
C. While it is important to communicate changes in the client's condition to the healthcare provider, this action should occur after the nurse has assessed the client's vital signs and determined the urgency of the situation. If the client is stable and responsive to initial interventions, the nurse can then contact the healthcare provider to discuss the new onset of atrial fibrillation and collaborate on further management.
D. Documenting the changes in the client's rhythm is important for continuity of care and communication among healthcare team members. However, obtaining a rhythm strip should not be the first action when a new onset of atrial fibrillation is observed. Assessing the client's vital signs and initiating appropriate interventions to address any hemodynamic instability take precedence.
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