The emergency department nurse is assessing a patient who is in the compensatory stage of hypovolemic shock. Which manifestations does the nurse expect? Select all that apply.

Elevated heart rate.

Elevated respiratory rate.

Decreased pulse rate.

Decrease systolic blood pressure.

Decreased urine output.

Bilateral crackles in the lung bases.

Answer and Explanation

Correct Answer : A,B,D,E

These manifestations occur as compensatory mechanisms in response to decreased blood volume and compromised tissue perfusion. The body attempts to compensate for the inadequate circulating volume by increasing heart rate (A) and respiratory rate (B) to enhance oxygen delivery.
D. The decreased systolic blood pressure (D) is a result of decreased cardiac output and vasoconstriction in an attempt to maintain perfusion to vital organs.
E. The decreased urine output (E) is a result of decreased renal perfusion due to decreased blood volume.
C. Decreased pulse rate in (option C) is incorrect because it is not typically seen in the compensatory stage of hypovolemic shock. The body tries to increase heart rate to maintain cardiac output and compensate for the decreased blood volume.
F. Bilateral crackles in (option F) is incorrect because the lung bases are more commonly associated with conditions such as pulmonary edema or fluid overload, rather than the compensatory stage of hypovolemic shock.
It's important to note that the manifestations of shock can vary depending on individual patient factors and the underlying cause of shock. Therefore, a comprehensive assessment and clinical judgment are necessary to fully evaluate the patient's condition.

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Correct Answer is ["18"]

Explanation

Step 1: Convert the patient's weight from pounds to kilograms. 130 pounds ÷ 2.205 (1 pound = 0.453592 kilograms) ≈ 58.97 kilograms

Step 2: Calculate the total dosage of Dobutamine required per hour based on the weight-specific dose. 2.5 mcg/kg/min × 58.97 kg = 147.425 mcg/min

Step 3: Calculate the infusion rate (mL/hr) using the concentration of Dobutamine in the prepared solution. The solution contains 250 mg of Dobutamine in 500 mL, which means there are 250,000 mcg of Dobutamine in 500 mL. To determine the mL/hr, divide the required dosage (147.425 mcg/min) by the amount of Dobutamine in 500 mL (250,000 mcg) and multiply by 500 mL (volume of the solution).

(147.425 mcg/min ÷ 250,000 mcg) × 500 mL ≈ 0.295 mL/min

To get the mL/hr, we convert the rate from minutes to hours (60 minutes = 1 hour):

0.295 mL/min × 60 min/hr ≈ 17.7 mL/hr

Round the answer to the nearest whole number:

Approximately 18 mL/hr of Dobutamine should be administered to the patient.

Correct Answer is ["9"]

Explanation

Doseinmcg/min=2mcg/kg/min×60kg=120mcg/min

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

120mcg/min=0.12mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120mcg/min=0.12mg/min
Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200mg250mL=0.8mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250mL200mg=0.8mg/mL
Calculate the pump rate in mL/min:

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

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

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

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

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

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

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The emergency department nurse is assessing a patient who is in the compensatory stage of hypovolemic shock. Which manifestations does the nurse expect? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["18"]

Explanation

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)

Correct Answer is ["9"]

Explanation

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