The nurse is administering low dose dopamine to a client who is in septic shock. Which physiologic parameter should the nurse use to evaluate a therapeutic response to the dopamine?
Temperature.
Heart sounds.
Urinary output.
Pupil response.
The Correct Answer is C
A. Temperature. While temperature monitoring is important in septic shock to assess infection control, it is not an indicator of dopamine's effectiveness. Dopamine primarily affects renal perfusion and blood pressure, not body temperature regulation.
B. Heart sounds. Dopamine is a vasopressor and inotropic agent, but it does not directly impact heart sounds. While it can increase myocardial contractility, assessing blood pressure and perfusion parameters is more relevant in evaluating its therapeutic effects.
C. Urinary output. Low-dose dopamine (1-5 mcg/kg/min) primarily acts as a dopaminergic agonist, increasing renal blood flow and urine output by dilating renal arteries. In septic shock, maintaining adequate kidney perfusion is critical to prevent acute kidney injury (AKI). A therapeutic response to dopamine would be seen as improved urinary output (≥ 30 mL/hr), indicating effective renal perfusion.
D. Pupil response. Dopamine does not directly affect pupil size or reactivity. Pupil assessment is more relevant in neurological evaluations, not in monitoring the effects of dopamine in septic shock.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Determine patellar tendon reflex response. The patellar reflex (knee jerk) assesses function of the L2-L4 spinal nerves, which are below the level of injury (C8-T1) and do not provide information about upper extremity function. While deep tendon reflexes are important, they do not help assess function at the suspected injury level.
B. Check the urinary bladder for distention. Bladder function is controlled by the sacral spinal nerves (S2-S4), which are much lower than the injury level. While bladder dysfunction is common in spinal cord injuries, it does not assess C8-T1 nerve function specifically.
C. Ask the client to grasp an object or form a fist. The C8 and T1 spinal nerves control hand and finger movements, including grip strength. Testing the client’s ability to grasp an object or form a fist helps assess fine motor function and nerve integrity at the injury level. This is the most appropriate way to determine function in the lower cervical and upper thoracic spinal nerves.
D. Apply resistance while the client lifts the legs. Leg movement is controlled by the lumbar and sacral spinal nerves (L2-S2), which are below the injury level. Assessing leg strength does not provide relevant information about C8-T1 function.
Correct Answer is C
Explanation
A. Temperature. While temperature monitoring is important in septic shock to assess infection control, it is not an indicator of dopamine's effectiveness. Dopamine primarily affects renal perfusion and blood pressure, not body temperature regulation.
B. Heart sounds. Dopamine is a vasopressor and inotropic agent, but it does not directly impact heart sounds. While it can increase myocardial contractility, assessing blood pressure and perfusion parameters is more relevant in evaluating its therapeutic effects.
C. Urinary output. Low-dose dopamine (1-5 mcg/kg/min) primarily acts as a dopaminergic agonist, increasing renal blood flow and urine output by dilating renal arteries. In septic shock, maintaining adequate kidney perfusion is critical to prevent acute kidney injury (AKI). A therapeutic response to dopamine would be seen as improved urinary output (≥ 30 mL/hr), indicating effective renal perfusion.
D. Pupil response. Dopamine does not directly affect pupil size or reactivity. Pupil assessment is more relevant in neurological evaluations, not in monitoring the effects of dopamine in septic shock.
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