A nurse is planning care for a client who has neurogenic shock following a spinal cord injury. Which of the following provider prescriptions should the nurse anticipate? (Select all that apply.)
(Select All that Apply.)
Metoprolol
Lactated Ringers intravenous fluid
Furosemide
Dopamine
Epinephrine
Correct Answer : B,D,E
Choice A Reason:
Metoprolol is incorrect. Metoprolol is a beta-blocker medication commonly used to treat conditions such as hypertension, angina, and heart failure. However, in the context of neurogenic shock following a spinal cord injury, the use of beta-blockers such as metoprolol is generally contraindicated. Beta-blockers antagonize the effects of sympathetic activation, leading to a reduction in heart rate and myocardial contractility, which can exacerbate hypotension and bradycardia, the hallmarks of neurogenic shock. Therefore, the nurse would not anticipate a prescription for metoprolol in the management of neurogenic shock.
Choice B Reason:
Lactated Ringers intravenous fluid is correct. Fluid resuscitation with isotonic crystalloid solutions such as lactated Ringers is essential to restore intravascular volume and improve perfusion.
Choice C Reason:
Furosemide is incorrect. Furosemide is a loop diuretic medication commonly used to treat conditions such as heart failure, edema, and hypertension by promoting diuresis and reducing fluid volume. However, in the context of neurogenic shock, the use of diuretics such as furosemide is generally not indicated unless there is concurrent volume overload. Neurogenic shock is characterized by hypotension due to vasodilation and decreased systemic vascular resistance, often leading to relative hypovolemia rather than volume overload. Therefore, administering furosemide could further decrease intravascular volume, exacerbating hypotension and compromising perfusion. As a result, the nurse would not anticipate a prescription for furosemide in the management of neurogenic shock.:
Choice D Reason:
Dopamine is correct. Dopamine is a vasopressor medication that acts to increase vascular tone and blood pressure by stimulating alpha-adrenergic receptors. It is commonly used in the management of neurogenic shock to augment blood pressure.
Choice E Reason:
Epinephrine is correct. Epinephrine is a potent vasopressor that acts on both alpha and beta-adrenergic receptors, leading to vasoconstriction and increased cardiac output. It is used in the treatment of refractory hypotension in neurogenic shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Flail chest is incorrect. Flail chest is a condition characterized by multiple rib fractures, causing instability in the chest wall. While it can lead to respiratory distress, it doesn't directly cause ventilation-perfusion (V/Q) mismatch. Instead, it impairs the mechanics of breathing by compromising chest wall integrity.
Choice B Reason:
Emphysema is a chronic obstructive pulmonary disease (COPD) where the alveolar walls are destroyed, leading to a loss of surface area for gas exchange. This results in areas of the lungs that are well-perfused but poorly ventilated, causing a V/Q mismatch. The damage to alveoli leads to impaired ventilation, while blood flow may still be adequate, leading to hypoxemia (low oxygen levels in the blood).
Choice C Reason:
CHF primarily affects the heart’s ability to pump blood effectively, leading to pulmonary congestion and impaired gas exchange. However, it typically causes diffusion defects rather than a direct ventilation-perfusion mismatch. V/Q mismatch may occur secondary to pulmonary edema, but it’s not the primary mechanism of respiratory failure in CHF.
Choice D Reason:
Guillain-Barré syndrome is incorrect. Guillain-Barré syndrome (GBS) is a neurological disorder that affects the peripheral nervous system, leading to muscle weakness and paralysis. While respiratory muscle weakness can occur in GBS, it doesn't directly cause ventilation-perfusion (V/Q) mismatch. GBS primarily affects nerve function rather than lung function.
Correct Answer is B
Explanation
Choice A Reason:
Nutritional therapy is not appropriate. While nutritional therapy may be involved in assessing the client's overall nutritional status and dietary needs, it may not specifically address the swallowing difficulty associated with Parkinson's disease.
Choice B Reason:
Speech therapy is appropriate. Speech therapy, also known as speech-language pathology, plays a crucial role in assessing and managing dysphagia. Speech therapists can evaluate the client's swallowing function and provide interventions to improve swallowing safety and efficiency.
Choice C Reason:
Occupational therapy is incorrect. Occupational therapy focuses on helping individuals engage in meaningful activities of daily living. While occupational therapists may play a role in dysphagia management, speech therapy is typically the primary discipline involved in addressing swallowing difficulties.
Choice D Reason:
Respiratory therapy: Respiratory therapy primarily focuses on evaluating and managing respiratory conditions, such as asthma, chronic obstructive pulmonary disease (COPD), and ventilator support. While dysphagia can sometimes lead to aspiration pneumonia and respiratory complications, respiratory therapists are not typically involved in the assessment and management of dysphagia itself.
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