A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect
Oxygen saturation 96%
PaCO2 30 mm Hg
Decrease in protein
Increase in BP
The Correct Answer is D
A. Oxygen saturation 96%:
Oxygen saturation at 96% is within the normal range and may not be directly influenced by the infusion of albumin. Albumin administration is more related to improving intravascular volume and blood pressure.
B. PaCO2 30 mm Hg:
The partial pressure of carbon dioxide (PaCO2) is a measure of respiratory status. Albumin infusion is not directly associated with changes in PaCO2.
C. Decrease in protein:
Albumin is a protein, and its infusion would not lead to a decrease in protein levels. In fact, albumin administration increases the oncotic pressure in the intravascular space, helping to retain fluid and improve blood volume.
D. Increase in BP:
This is the correct answer. Albumin is a colloid solution that increases oncotic pressure in the bloodstream. By increasing oncotic pressure, albumin helps to draw fluid from the interstitial space into the vascular space, thereby increasing blood volume. This can contribute to an increase in blood pressure, which is a desired effect in the management of shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. INR (International Normalized Ratio): INR is a measure of blood clotting and is not directly affected by filgrastim, which stimulates the production of white blood cells. Monitoring INR is more relevant when assessing anticoagulant therapy.
B. Potassium level: Filgrastim does not directly influence potassium levels. Monitoring potassium is important for certain medications and conditions, but it is not the primary parameter to evaluate the effectiveness of filgrastim.
C. WBC count: Filgrastim (granulocyte colony-stimulating factor) is used to stimulate the production of white blood cells, specifically neutrophils. Monitoring the white blood cell count is crucial in evaluating the effectiveness of filgrastim treatment. An increase in the WBC count, particularly the neutrophil count, indicates a positive response to the medication.
D. BUN (Blood Urea Nitrogen): BUN is a measure of kidney function and is not directly influenced by filgrastim. While monitoring kidney function is important in general patient care, it is not the primary parameter to assess the effectiveness of filgrastim.
Correct Answer is D
Explanation
A. Inform the client there is a prescription available if needed:
This response does not address the urgency indicated by the prescription stating "NOW." It is essential to take immediate action when the prescription indicates an urgent administration.
B. Notify the pharmacy to send the medication immediately:
While timely medication administration is crucial, contacting the pharmacy directly without clarification from the provider may lead to misinterpretation or errors. It's important to confirm the prescription details first.
C. Administer the medication within 90 minutes:
The prescription indicating "NOW" suggests a need for more immediate administration than within 90 minutes. Waiting for 90 minutes may not be in line with the urgency implied by the prescription.
D. Contact the provider to clarify the prescription:
This is the correct action. The prescription is ambiguous, and the nurse should seek clarification from the provider regarding the urgency of administration, the reason for the medication, and any other pertinent details to ensure safe and appropriate care.
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