A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose diphenhydramine is to prevent which of the following manifestations of a transfusion reaction?

Low-back pain

Fever

Dyspnea

Urticaria

Answer and Explanation

The Correct Answer is D

A) Low-back pain:
Low-back pain is not typically associated with transfusion reactions. While certain complications of blood transfusions, such as transfusion-related acute lung injury (TRALI) or hemolytic reactions, can cause back pain, diphenhydramine is not specifically administered to prevent this manifestation.

B) Fever:
Fever can be a manifestation of various transfusion reactions, including febrile non-hemolytic reactions or bacterial contamination of blood products. However, diphenhydramine is not typically administered to prevent fever associated with transfusion reactions. Instead, measures such as leukoreduction of blood products or premedication with acetaminophen may be used to reduce the risk of febrile reactions.

C) Dyspnea:
Dyspnea, or difficulty breathing, can occur in severe transfusion reactions such as transfusion-related acute lung injury (TRALI) or anaphylaxis. While diphenhydramine may be part of the treatment for anaphylaxis, it is not specifically administered to prevent dyspnea associated with transfusion reactions.

D) Urticaria.
Urticaria, commonly known as hives, is a common manifestation of an allergic transfusion reaction. Diphenhydramine is an antihistamine medication that can help prevent or alleviate allergic reactions, including urticaria, by blocking the action of histamine, a substance released during allergic reactions. Administering diphenhydramine before a blood transfusion is a preventive measure to reduce the risk of allergic transfusion reactions, including urticaria.

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Correct Answer is C

Explanation

A) Lowered heart rate:
Dopamine typically increases heart rate as it acts on beta-adrenergic receptors in the heart, leading to increased cardiac contractility and chronotropy. However, at low doses, the effect on heart rate may be minimal compared to higher doses.

B) Decreased conduction through the AV node:
Dopamine may have minimal effects on conduction through the atrioventricular (AV) node, especially at low doses. It primarily acts on adrenergic receptors to increase cardiac contractility and heart rate.

C) Increased urine output.
Dopamine is a medication commonly used to treat shock by improving cardiac output and blood pressure. At low doses, dopamine primarily acts on dopamine receptors in the renal blood vessels, causing vasodilation and increased renal blood flow. This increased renal blood flow leads to increased glomerular filtration rate (GFR) and urine output. Therefore, increased urine output is an expected effect of dopamine infusion at low doses in the treatment of shock.

D) Vasoconstriction of renal blood vessels:
At low doses, dopamine primarily acts on dopamine receptors in the renal blood vessels, causing vasodilation and increased renal blood flow. Vasoconstriction of renal blood vessels is more commonly associated with higher doses of dopamine or with other vasopressor medications such as norepinephrine or phenylephrine.

A. At high doses, to treat anaphylaxis. B. At high doses, to increase cardiac output. C. At low doses, to cause increased blood flow to the kidneys. D. At low doses, to treat anaphylaxis. E. To cause vasoconstriction and increase blood pressure.

Correct Answer is ["B","C","E"]

Explanation

A. At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.

B. At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.

C. At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.

D. At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.

E. To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.

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A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose diphenhydramine is to prevent which of the following manifestations of a transfusion reaction?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of a client who is receiving a dopamine infusion at a low dose for treatment of shock. Which of the following findings is an expected effect of this medication?

Correct Answer is C

Explanation

The patient's family is asking questions about the medications used in the treatment for shock. The nurse explains that dopamine is one of the drugs being used and that it works: (Select All that Apply.)

Correct Answer is ["B","C","E"]

Explanation

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A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose of diphenhydramine is to prevent which of the following manifestations of a transfusion reaction?