A client who is hypotensive is receiving dopamine, an adrenergic agonist, IV at the rate of 8 mcg/kg/min. Which intervention should the nurse implement while administering this medication?
Assess pupillary response to light hourly.
Initiate seizure precautions.
Monitor serum potassium frequently.
Measure urinary output every hour.
The Correct Answer is D
A. Assess pupillary response to light hourly: Dopamine administration may cause changes in pupillary response, but it is not the primary concern associated with its administration. Hourly pupillary assessment may not be necessary unless other signs of neurological changes are present.
B. Initiate seizure precautions: While dopamine administration may cause neurological effects, such as agitation or tremors, it is not typically associated with seizure activity. Seizure precautions are not indicated solely due to dopamine infusion.
C. Monitor serum potassium frequently: Dopamine administration can affect potassium levels, but monitoring serum potassium levels frequently may not be necessary unless the client has pre- existing potassium imbalances or is at risk for electrolyte disturbances.
D. Measure urinary output every hour: Dopamine is a vasopressor medication that can increase blood pressure and cardiac output, potentially leading to increased renal perfusion and urinary output. Monitoring urinary output hourly is essential to assess the client's response to dopamine therapy and ensure adequate renal function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Provide bedside equipment for transmission and protective precautions: While infection control precautions are important, obtaining cultures to identify the source of infection and guide treatment is the priority in this scenario.
B. Evaluate daily serum electrolytes and hydration status: While monitoring electrolytes and hydration is important in critically ill patients, it is not the priority in this situation where the client is presenting with signs of systemic infection.
C. Culture sputum, urine, burn wound, and all intravenous access sites: The priority is to obtain cultures to identify the source of infection, which will guide antibiotic therapy and other
interventions.
D. Implement central line-associated bloodstream infection: While preventing central line- associated bloodstream infection is important, it is not the priority in this situation where the client is presenting with signs of systemic infection.
Correct Answer is ["A","D","E"]
Explanation
A. Obtain postoperative vital signs: This task is within the scope of practice for a practical nurse (PN) as it involves monitoring and recording the vital signs of a client post-surgery, which is a fundamental nursing skill.
B. Start the second blood transfusion: This task is typically reserved for a registered nurse (RN) due to the complexity and potential complications associated with blood transfusions.
C. Initiate PCA pumps: The initiation of PCA pumps is generally a responsibility of the RN because it requires assessment and understanding of the medication dosage and patient pain management needs.
D. Perform daily surgical dressing change: This is an appropriate task for a PN as it involves wound care and monitoring for signs of infection, which are within the PN's capabilities.
E. Administer a dose of insulin per sliding scale: Administering medications, including insulin, is a task that can be delegated to a PN, provided they have the knowledge and skills to do so safely.
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