The patient's family is asking questions about the medications used in the treatment for shock. The nurse explains that dopamine is one of the drugs being used and that it works:
(Select All that Apply.)
At high doses, to treat anaphylaxis.
At high doses, to increase cardiac output.
At low doses, to cause increased blood flow to the kidneys.
At low doses, to treat anaphylaxis.
To cause vasoconstriction and increase blood pressure.
Correct Answer : B,C,E
A. At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.
B. At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.
C. At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.
D. At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.
E. To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Respirations rate:
Respiratory rate is an important vital sign to monitor in patients with shock, as respiratory distress can indicate inadequate oxygenation. However, blood pressure is generally considered more critical to assess initially in the context of shock because it directly reflects tissue perfusion and oxygen delivery.
B) Heart rate:
Heart rate is an important vital sign to monitor in patients with shock, as tachycardia (rapid heart rate) may indicate the body's compensatory response to maintain cardiac output and tissue perfusion. However, blood pressure is generally considered more critical to assess initially in the context of shock because it directly reflects tissue perfusion and oxygen delivery.
C) Blood pressure.
In shock, the body's vital organs are not receiving adequate blood flow and oxygen, leading to a life-threatening condition. While all vital signs are important to monitor in a patient experiencing shock, blood pressure is typically considered the most critical because it reflects the perfusion pressure—the force driving blood through the circulatory system to deliver oxygen and nutrients to the body's tissues. A decrease in blood pressure can indicate inadequate tissue perfusion and impending organ failure. Therefore, timely assessment and monitoring of blood pressure are essential for identifying and managing shock effectively.
D) Temperature:
Temperature monitoring is important in assessing for signs of infection or other systemic issues that may contribute to shock, such as sepsis. However, blood pressure is generally considered more critical to assess initially in the context of shock because it directly reflects tissue perfusion and oxygen delivery.
Correct Answer is D
Explanation
A) Low-back pain:
Low-back pain is not typically associated with transfusion reactions. While certain complications of blood transfusions, such as transfusion-related acute lung injury (TRALI) or hemolytic reactions, can cause back pain, diphenhydramine is not specifically administered to prevent this manifestation.
B) Fever:
Fever can be a manifestation of various transfusion reactions, including febrile non-hemolytic reactions or bacterial contamination of blood products. However, diphenhydramine is not typically administered to prevent fever associated with transfusion reactions. Instead, measures such as leukoreduction of blood products or premedication with acetaminophen may be used to reduce the risk of febrile reactions.
C) Dyspnea:
Dyspnea, or difficulty breathing, can occur in severe transfusion reactions such as transfusion-related acute lung injury (TRALI) or anaphylaxis. While diphenhydramine may be part of the treatment for anaphylaxis, it is not specifically administered to prevent dyspnea associated with transfusion reactions.
D) Urticaria.
Urticaria, commonly known as hives, is a common manifestation of an allergic transfusion reaction. Diphenhydramine is an antihistamine medication that can help prevent or alleviate allergic reactions, including urticaria, by blocking the action of histamine, a substance released during allergic reactions. Administering diphenhydramine before a blood transfusion is a preventive measure to reduce the risk of allergic transfusion reactions, including urticaria.
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