46) While walking down the street, a cat jumps out of an alley into the pathway of an adult. They note that his /her heart is "racing." this response is primarily due to:

A) Norepinephrine (Levophed): Norepinephrine is a potent vasoconstrictor primarily used in acute hypotensive states to raise blood pressure. It is not indicated for the treatment of seasonal rhinitis, as its primary effect is not on the nasal passages or the symptoms associated with allergies, such as congestion.

B) Dopamine (Intropin): Dopamine is typically used in critical care settings for conditions such as shock and low blood pressure. While it affects dopaminergic and adrenergic receptors to improve renal perfusion and increase heart rate, it is not used to treat conditions like seasonal rhinitis, which involve nasal congestion.

C) Ephedrine (generic): Ephedrine is a sympathomimetic drug that stimulates alpha-adrenergic receptors, leading to vasoconstriction in the nasal passages and a reduction in swelling and congestion. This makes it a suitable choice for managing the symptoms of seasonal rhinitis, as it helps relieve nasal congestion by constricting blood vessels in the nasal mucosa.

D) Dobutamine (Dobutrex): Dobutamine is primarily used in the treatment of heart failure and shock because it increases heart rate and cardiac output. It does not have the properties needed to alleviate nasal congestion in rhinitis and is therefore not appropriate for this condition.

A) Breath sounds: Prior to administering Atrovent (Ipratropium Bromide), it is essential for the nurse to assess the child’s breath sounds. Ipratropium is an anticholinergic medication used to relieve bronchospasm in conditions like asthma or chronic obstructive pulmonary disease (COPD). By evaluating breath sounds, the nurse can assess the severity of the respiratory condition and monitor for any wheezing or crackles, which may indicate the need for further intervention or adjustment of the treatment.
B) Cardiac disorders: While some caution may be warranted in patients with cardiac disorders when using certain medications (e.g., sympathomimetics), Ipratropium Bromide is an anticholinergic agent that primarily affects the respiratory system. It is not directly contraindicated in children with cardiac disorders, so assessing for cardiac conditions is not the most critical initial assessment when administering this drug.
C) Recent injuries: Recent injuries do not specifically relate to the need for assessment prior to administering Ipratropium. This medication targets the lungs and airways, so assessing for recent injuries would not be as pertinent unless the injuries impacted the child’s ability to breathe (e.g., rib fractures, lung trauma).
D) Hypertension: Hypertension is not a primary concern when administering Ipratropium Bromide. While anticholinergic drugs should be used cautiously in certain individuals (e.g., those with glaucoma or urinary retention), hypertension is not a contraindication for this medication. It would be more critical to assess for respiratory status, particularly breath sounds, to evaluate the efficacy of the treatment.