A 61-year-old female patient with hypovolemic shock has these vital signs: temperature 97.9°F (36.6°C): pulse 123 beats/min: blood pressure 85/48 mamite respirations 24 breaths/min; urine output 20 mL for last 2 hours: skin cool and clammy. Which prescription order for this patient does the nurse question?

Doasive Nitrogen 12m mi

Dobutamine Doubters) 5 mcg/kg/min

Plasmanate 1 unit

Bumetanide (Bumex) 1 mg IV

Answer and Explanation

The Correct Answer is C

Hypovolemic shock is a life-threatening condition resulting from severe blood or fluid loss. The patient in this scenario exhibits signs of hypovolemic shock, such as low blood pressure, tachycardia, cool and clammy skin, and decreased urine output.
When assessing the prescription options, the nurse should consider the appropriateness of each intervention for hypovolemic shock. Plasmanate is a type of plasma protein fraction that is used for volume expansion in certain situations. However, in hypovolemic shock, the primary intervention is to restore intravascular volume promptly. Plasmanate alone may not be sufficient for rapid-volume resuscitation.
In hypovolemic shock, the initial management typically involves the administration of crystalloid solutions, such as Lactated Ringers or Normal Saline, to restore intravascular volume. Therefore, the prescription of Plasmanate as the primary intervention raises concerns and should be questioned by the nurse.
A. Dopamine (Intropin) 12 mcg/min in (option A) is incorrect because: Dopamine is a vasopressor medication used to increase blood pressure and cardiac output. It is a suitable option for hypovolemic shock to support blood pressure and tissue perfusion.
B. Dobutamine (Dobutrex) 5 mcg/kg/min in (option B) is incorrect because: Dobutamine is an inotropic medication that helps improve cardiac contractility and cardiac output. It can be beneficial in cases of hypovolemic shock with signs of poor cardiac function.
D. Bumetanide (Bumex) 1 mg IV in (option D) is incorrect because: Bumetanide is a loop diuretic used to promote diuresis. However, in the context of hypovolemic shock, diuretics are generally not the first-line treatment as they can further reduce intravascular volume and worsen the patient's condition.
It is essential for the nurse to consult with the healthcare provider regarding the prescription order of Plasmanate and consider alternative interventions for rapid volume resuscitation in hypovolemic shock.

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Correct Answer is D

Explanation

Septic shock is a life-threatening condition characterized by severe infection, systemic inflammation, and inadequate tissue perfusion. Hypotension, as indicated by a low blood pressure reading, is a significant concern in septic shock. It reflects inadequate perfusion to vital organs and tissues, leading to potential organ dysfunction and damage.
While all the assessment data provided may be important and require attention, the low blood pressure (BP) reading indicates impaired systemic perfusion and can contribute to end-organ damage. The nurse should prioritize interventions aimed at improving perfusion and stabilizing the patient's blood pressure.
A. Arterial oxygen saturation is 90% in (option A) is incorrect because While an arterial oxygen saturation of 90% is below the desired range, it is not as immediately life-threatening as low blood pressure. Oxygen therapy and interventions to improve oxygenation should still be initiated, but addressing hypotension takes priority.
B. Urine output of 15 ml for 2 hours in (option B) is incorrect because Decreased urine output is a concerning sign, as it may indicate impaired renal perfusion. However, the immediate concern in septic shock is addressing the low blood pressure to improve overall perfusion, including renal perfusion.
C. Apical pulse 110 beats/min in (option C) is incorrect because: Tachycardia is a common finding in septic shock and represents the body's compensatory response to maintain cardiac output. While it requires monitoring and consideration, low blood pressure is a more significant concern.

A. 18 Ml B. 5480 Ml C. 6,480 mL D. 4234 mL

Correct Answer is C

Explanation

Heart rate: 72 beats per minute Stroke volume: 90 mL/contraction

Cardiac output = Heart rate × Stroke volume

Cardiac output = 72 beats/minute × 90 mL/contraction

To simplify the calculation, you can convert the units:

72 beats/minute × 90 mL/contraction = (72 × 90) beats/minute × mL/contraction

Now, perform the multiplication:

72 × 90 = 6,480

Therefore, the cardiac output is 6,480 mL per minute.

The correct answer is:

C. 6,480 mL

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Naxlex Comprehensive Predictor Exams

When caring for a patient weighing 60 kg who has just been admitted with septic shock, which of these assessment data greatest concern to the nurse?

Correct Answer is D

Explanation

What is the cardiac output of a patient whose heart rate is 72 beats per minute with a stroke volume of 90 mL/contraction?

Correct Answer is C

Explanation

A 31-year-old male patient with burn injuries is admitted to the burn unit. Which priority does the nurse anticipate within the first 24 hours?

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The nurse needs to estimate quickly the heart rate of a patient with a regular heart rhythm. Which method will be best to use?

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