Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)

Answer and Explanation

The Correct Answer is ["9"]

Dose in mcg/min=2 mcg/kg/min×60 kg=120 mcg/min

Convert this to mg/min since the concentration is in mg:

120 mcg/min=0.12 mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120 mcg/min=0.12 mg/min
Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200 mg250 mL=0.8 mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250 mL200 mg=0.8 mg/mL
Calculate the pump rate in mL/min:

To find the rate in mL/min needed to deliver 0.12 mg/min:

Pump rate=Desired dose (mg/min)Concentration (mg/mL)\text{Pump rate} = \frac{\text{Desired dose (mg/min)}}{\text{Concentration (mg/mL)}}Pump rate=Concentration (mg/mL)Desired dose (mg/min)

Pump rate=0.12 mg/min0.8 mg/mL=0.15 mL/min\text{Pump rate} = \frac{0.12 \text{ mg/min}}{0.8 \text{ mg/mL}} = 0.15 \text{ mL/min}Pump rate=0.8 mg/mL0.12 mg/min=0.15 mL/min
Convert the pump rate to mL/hour:

Multiply by 60 to convert from mL/min to mL/hour:

Pump rate=0.15 mL/min×60 min/hour=9 mL/hour\text{Pump rate} = 0.15 \text{ mL/min} \times 60 \text{ min/hour} = 9 \text{ mL/hour}Pump rate=0.15 mL/min×60 min/hour=9 mL/hour

So, you should set the pump to deliver Dopamine at a rate of 9 mL/hour.

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Correct Answer is A

Explanation

The stages of shock are commonly described as the initial, compensatory, progressive, and refractory stages. Here is an explanation of each stage and why the patient's assessment findings correspond to the progressive stage:
B. The compensatory stage in (option B) is incorrect because, In the compensatory stage, the body continues to activate compensatory mechanisms to maintain perfusion. This includes increased heart rate, peripheral vasoconstriction, and shunting of blood to vital organs. The patient's assessment findings of decreasing cardiac output, decreased peripheral perfusion, and increased capillary permeability suggest that the body's compensatory mechanisms are no longer sufficient to maintain perfusion adequately. Therefore, the patient has progressed beyond the compensatory stage.
C. The initial stage in (option C) is incorrect because, In the initial stage, there is an initial insult or injury that triggers the shock state. The body's compensatory mechanisms are activated, such as increased heart rate and vasoconstriction, to maintain blood pressure and perfusion. However, the patient's assessment findings indicate that they have progressed beyond the initial stage.
D. The refractory stage in (option D) is incorrect because The refractory stage represents a severe and irreversible state of shock where vital organs fail, and despite interventions, the patient's condition does not improve. The patient's assessment findings do not suggest the refractory stage, as there is still potential for intervention and management.

A. Decreased blood volume B. Increased Increased vascular permeability C. peripheral resistance D. Development of edema

Correct Answer is A,B,D,C

Explanation

A. Decreased blood volume: Burn injuries can lead to fluid loss, primarily through damaged skin. This fluid loss causes a decrease in blood volume, leading to hypovolemia. Hypovolemia contributes to decreased cardiac output and tissue perfusion.
B. Increased vascular permeability: Burn injuries cause an inflammatory response, leading to increased vascular permeability. This increased permeability allows fluid, electrolytes, and proteins to leak from the intravascular space into the interstitial space.
C. Development of edema: The increased vascular permeability and fluid leakage lead to the development of edema. Edema occurs as fluid accumulates in the interstitial spaces, further contributing to tissue swelling and compromised perfusion.
D. Increased peripheral resistance: In response to decreased blood volume and tissue hypoperfusion, the body activates compensatory mechanisms to maintain blood pressure and tissue perfusion. One of these mechanisms is increased peripheral resistance, which occurs as blood vessels constrict to maintain blood pressure. Increased peripheral resistance helps redirect blood flow to vital organs but also contributes to increased workload on the heart.
Therefore, the correct sequential order of events involved in burn shock following a patient's exposure to burns is:
A. Decreased blood volume B. Increased vascular permeability D. Development of edema C. Increased peripheral resistance

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Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The ICU nurse provides care for a 67-year-old female patient experiencing a distributive shock. Assessment findings are indicative of decreasing cardiac output, decreased peripheral perfusion, and increased capillary permeability. The nurse identifies that the patient is in which stage of shock.

Correct Answer is A

Explanation

A 32-year-old male patient sustains 78% TBSA burn and is currently admitted to the burn unit. Which sequential order would the nurse arrange the events involved in burn shock following a patient's exposure to burns?

Correct Answer is A,B,D,C

Explanation

A 27-year-old male patient who has been involved in a motor vehicle crash is admitted to the emergency department with cool, clammy skin, tachypnoea, tachycardia, and hypotension. All of these orders are written. Which one will the nurse act on first?

The cardiac ICU nurse is assessing a patient who is in cardiogenic shock. Which hemodynamic manifestations and/or signs and symptoms do the nurse expect? Select all that apply.

Which conditions can cause hypovolemic shock? Select all that apply.

The nurse is caring for a patient who has septic shock. Which assessment finding is most important for the nurse to report to the health care provider?

When assessing the hemodynamic information for a newly admitted patient in shock of unknown etiology, the emergency department nurse will anticipate the administration of large volumes of Lactated Ringers (LR) when which one of the following occurs?

A 40-year-old female patient with massive trauma and possible spinal cord injury is admitted to the emergency department (ED). The nurse suspects that the patient may be experiencing neurogenic shock in addition to hypovolemic shock, based on which one of the following?

The patient weighing 147 pounds with septic shock has a BP of 70/46 mm Hg, pulse 136, respirations 30, temperature 104° F, and blood glucose 391 mg/dL. Which intervention red by the health care provider should the nurse implement first?