A nurse is caring for a client who has a contusion of the brainstem and reports thirst. The client's urinary output was 4,000 mL over the past 24 hours. The nurse should anticipate a prescription for which of the following intravenous (IV) medications?
Epinephrine
Furosemide
Nitroprusside
Desmopressin
The Correct Answer is D
Choice A reason: Epinephrine is primarily used in emergency situations for its vasoconstrictive and bronchodilatory effects, particularly in cases of anaphylaxis or cardiac arrest. It is not typically used to manage symptoms associated with brainstem contusions or to regulate urinary output.
Choice B reason: Furosemide is a loop diuretic commonly prescribed to reduce fluid retention in conditions such as heart failure or renal disease. Given that the client has already produced a large volume of urine (4,000 mL in 24 hours, which is above the normal range of 800 to 2,000 milliliters per day), administering furosemide would not be appropriate as it would likely exacerbate the excessive urinary output.
Choice C reason: Nitroprusside is a potent vasodilator used to treat acute hypertensive crises. It has no role in the management of thirst or regulation of urinary output and is not indicated for the treatment of brainstem contusions.
Choice D reason: Desmopressin is a synthetic analogue of the naturally occurring antidiuretic hormone vasopressin. It is used to treat conditions characterized by excessive urination, such as diabetes insipidus, and to manage polyuria and polydipsia (excessive thirst) following head trauma or surgery in the pituitary region. In the context of a brainstem contusion with a reported high urinary output, desmopressin would be the appropriate medication to prescribe to reduce urine volume and address the client's thirst.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Anticonvulsants are medications used to prevent seizures. While seizures can occur after a stroke, anticonvulsants are not routinely prescribed unless the patient has a history of seizures or has experienced seizures post-stroke. Therefore, anticonvulsants would not be the standard pharmacologic therapy for all patients being discharged after an ischemic stroke.
Choice B reason: Diuretics are used to remove excess fluid from the body and are commonly prescribed for conditions such as heart failure or high blood pressure. They are not typically used as a standard treatment for ischemic stroke unless the patient has a specific condition that requires fluid management.
Choice C reason: Antithrombotic agents, such as aspirin or clopidogrel, are commonly prescribed to patients after an ischemic stroke to prevent further clot formation and reduce the risk of recurrent strokes. These medications work by inhibiting platelet aggregation and are a key part of secondary prevention in stroke management.
Choice D reason: Opioid analgesics are strong painkillers that are used to treat severe pain. They are not typically prescribed upon discharge for ischemic stroke patients unless there is a specific indication for pain management that cannot be managed with other medications.
Correct Answer is A
Explanation
Choice A reason: "Your provider wouldn't prescribe this medication if it weren't necessary." This response acknowledges the client's concerns while also reinforcing the importance of the medication as part of their treatment plan.
Choice B reason: "If you don't take this medication, you will feel worse." This response may come across as threatening and may not effectively address the client's concerns or foster a trusting relationship.
Choice C reason: "Most clients feel better after taking the antibiotic." While this may be true, it does not directly address the client's individual concerns about medication necessity.
Choice D reason: "I will tell your provider that you do not want to take this medication." This response does not engage with the client's concerns and may make the client feel unheard.
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