The health care provider prescribes IV mannitol for a client with an intracranial pressure (ICP) of 22. How will the nurse determine that the medication had the intended effect?

Intracranial pressure (ICP) is now 15.

The patient voids 250 mL over 2 hours.

The patient's pupils are dilated and sluggish.

Seizure behavior is absent.

Answer and Explanation

The Correct Answer is A

A. Intracranial pressure (ICP) is now 15: Mannitol is an osmotic diuretic used to reduce intracranial pressure (ICP). The intended effect of the medication is to lower ICP. A decrease in ICP to 15 mmHg is within the normal range and indicates the medication has worked effectively.

B. The patient voids 250 mL over 2 hours is incorrect. While mannitol promotes diuresis, the amount of urine output alone does not directly indicate a reduction in ICP. The goal is to lower ICP, which is best assessed by measuring the ICP itself.

C. The patient's pupils are dilated and sluggish is incorrect. Dilated and sluggish pupils can be a sign of increased ICP, not a response to effective treatment.

D. Seizure behavior is absent is incorrect. While mannitol can help reduce ICP and potentially prevent seizures, the absence of seizure behavior is not a direct indicator of the medication's effect on ICP.

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Correct Answer is ["C","E","G","I"]

Explanation

A. Client should increase potassium-rich foods in the diet: Not applicable, as mitral valve prolapse (MVP) is not related to potassium levels.

B. Family members of the client should have a cardiac screening: This is unnecessary unless there is a strong family history of connective tissue disorders associated with MVP.

C. Client should notify the provider if palpitations develop: Palpitations can indicate arrhythmias, which are a possible complication of MVP.

D. Female clients should use measures to prevent pregnancy: Pregnancy is generally not contraindicated in MVP unless there is significant valve regurgitation.

E. Client should use caution when taking OTC medications: Stimulants in OTC drugs, like decongestants, can exacerbate palpitations.

F. Client should avoid extremely hot or cold environments: This is not typically required for MVP.

G. Client should be encouraged to quit smoking: Smoking can exacerbate cardiovascular risks associated with MVP.

H. Client requires prophylactic antibiotics before dental procedures: Not recommended unless there is a history of endocarditis or significant valve regurgitation.

I. Client should avoid high amounts of caffeine and alcohol: Both can exacerbate symptoms like palpitations and arrhythmias.

A. Heart rate of 134 bpm B. Mild shortness of breath C. Three premature ventricular contractions in a row D. Blood pressure 152/88 mmHg

Correct Answer is C

Explanation

A. Heart rate of 134 bpm. A heart rate of 134 bpm is expected during a cardiac stress test, as the goal is to increase the heart rate to a target range to evaluate cardiac function under stress.

B. Mild shortness of breath. Mild shortness of breath is a common response to exercise and is not an indication to stop the test unless it becomes severe or is accompanied by other concerning symptoms like chest pain or cyanosis.

C. Three premature ventricular contractions in a row indicate a potential serious arrhythmia (ventricular tachycardia), which is a contraindication for continuing the stress test. This finding could place the client at risk for life-threatening cardiac events, such as ventricular fibrillation.

D. Blood pressure 152/88 mmHg. This is a slightly elevated but normal physiological response to exercise and does not warrant discontinuation of the test unless the blood pressure rises to dangerously high levels (e.g., >200/110 mmHg).

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The health care provider prescribes IV mannitol for a client with an intracranial pressure (ICP) of 22. How will the nurse determine that the medication had the intended effect?

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