Which of the following is NOT an appropriate indication for the use of dopamine in critical care?
Hypotension due to neurogenic shock
Hypotension due to septic shock
Hypotension due to hypovolemic shock
Hypotension due to cardiogenic shock
The Correct Answer is C
C. its use in hypovolemic shock is generally not appropriate because the primary treatment for hypovolemic shock is fluid resuscitation to address the volume loss.
A. Dopamine is often used in neurogenic shock to increase systemic vascular resistance and improve blood pressure. Therefore, dopamine is an appropriate choice for the management of hypotension due to neurogenic shock.
B. Dopamine is commonly used in septic shock to improve cardiac output and systemic vascular resistance. It helps to support blood pressure and perfusion in septic shock patients.
D. It is indicated for cardiogenic shock as it increases cardiac contractility.
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Related Questions
Correct Answer is B
Explanation
B. Sodium nitroprusside is a potent vasodilator used to reduce systemic vascular resistance and afterload, thereby improving cardiac output and tissue perfusion in cardiogenic shock. In this scenario, where the patient has cool and clammy skin with high SVR, indicating peripheral vasoconstriction,
increasing the rate of sodium nitroprusside infusion can help vasodilate peripheral vessels, reduce afterload, and improve tissue perfusion
A. Dopamine is a medication commonly used in the management of cardiogenic shock to increase cardiac output and systemic blood pressure. However, in this scenario where the patient is cool and clammy with high SVR, indicating vasoconstriction and potential peripheral hypoperfusion, increasing the rate of dopamine infusion may further increase systemic vascular resistance and exacerbate peripheral vasoconstriction. This can worsen tissue perfusion and exacerbate the patient's condition.
.
C. Nitroglycerin is another vasodilator commonly used in the management of cardiogenic shock to reduce preload and afterload, thereby improving cardiac output and tissue perfusion. However, decreasing the rate of nitroglycerin infusion may further exacerbate vasoconstriction and increase SVR, worsening tissue perfusion in this scenario. Therefore, decreasing the rate of nitroglycerin infusion is not indicated.
D. Intravenous fluids such as 5% dextrose in normal saline are typically administered to maintain adequate intravascular volume and perfusion pressure in shock states. However, decreasing the rate of intravenous fluid infusion may further decrease intravascular volume and preload, potentially exacerbating hypoperfusion and worsening the patient's condition. Therefore, decreasing the rate of intravenous fluid infusion is not indicated in this scenario.
Correct Answer is []
Explanation
AF is characterized by irregular, rapid heartbeat (100 to 175 beats per minute (bpm) and the absence of distinct P waves.
Management of unstable atrial fibrillation include immediate pharmacological or electrical cardioversion and anticoagulation.
Atrial fibrillation leads to ineffective pumping and stasis of blood in the heart which increases the risk of stroke.
On initiating anticoagulation, PTT/INR is important to ensure that the drug is administered at doses that achieve the optimal therapeutic effect.
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