The client who is experiencing septic shock is started on norepinephrine by intravenous drip via pump. Which frequent assessments should the nurse prioritize while administering this medication? (Select All that Apply)

Color of conjunctiva

Deep tendon reflexes

IV Insertion site

Blood pressure and heart rate

Hourly urine output

Answer and Explanation

Correct Answer : C,D,E

A. Color of conjunctiva
While assessing for signs of perfusion is important, conjunctival color is not a primary assessment for norepinephrine administration. Perfusion is better assessed through blood pressure, heart rate, capillary refill, and urine output.

B. Deep tendon reflexes
Norepinephrine primarily affects vascular tone and cardiac output. Deep tendon reflexes are not a priority assessment for this medication.

C. IV Insertion site
Norepinephrine is a vasopressor, and extravasation can cause severe tissue necrosis. Frequent monitoring of the IV site is necessary to prevent complications.

D. Blood pressure and heart rate
Norepinephrine increases blood pressure and heart rate through vasoconstriction. Continuous monitoring is required to assess for excessive hypertension, tachycardia, or inadequate response to therapy.

E. Hourly urine output
Urine output is an essential indicator of organ perfusion. Since norepinephrine is used to maintain adequate blood pressure and perfusion in septic shock, monitoring urine output helps assess the effectiveness of treatment.

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Correct Answer is C

Explanation

A. Review dietary approaches to stop hypertension (DASH) choices in a client with primary HTN
Dietary education requires nursing judgment and assessment, which are outside the CNA’s scope of practice. This should be done by the RN or a dietitian.

B. With one other CNA, logroll a client who has had a bicycle accident
Logrolling is required in patients with spinal precautions, and an RN or physical therapist should oversee or perform the procedure to ensure proper spinal alignment.

C. Obtain a weight on a newly admitted client with diabetes
Measuring weight is within a CNA’s scope of practice, and it does not require clinical judgment. The CNA can obtain the weight and report findings to the RN.

D. Assist a client to the bathroom 1 hour after a lumbar puncture
A client who has undergone a lumbar puncture is at risk for post-procedure headaches and hypotension due to cerebrospinal fluid loss. The RN should assess the client first before allowing ambulation.

A. 20-gauge catheter in the the right wrist infusing IV antibiotics B. 20-gauge catheter in the the right forearm infusing 0.9% Normal Saline C. 22-gauge catheter in the left forearm infusing 0.45% Normal Saline D. 18-gauge infusing 20mg Potassium Chloride IV

Correct Answer is B

Explanation

A. 20-gauge catheter in the right wrist infusing IV antibiotics

Infusing antibiotics can cause incompatibilities.

B. 20-gauge catheter in the right forearm infusing 0.9% Normal Saline

A 20-gauge or larger catheter in a patent IV site with compatible fluid (NS) is required for PRBC transfusion.

C. 22-gauge catheter in the left forearm infusing 0.45% Normal Saline

A 22-gauge catheter is too small for safe transfusion.

D. 18-gauge infusing 20 mg Potassium Chloride IV

Potassium chloride infusion should not be interrupted, making this site unsuitable.

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The client who is experiencing septic shock is started on norepinephrine by intravenous drip via pump. Which frequent assessments should the nurse prioritize while administering this medication? (Select All that Apply)

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