A nurse is preparing to titrate a continuous nitroprusside infusion for a client. The nurse should plan to titrate the infusion according to which of the following assessments?

Stroke volume

Cardiac output

Urine output

Blood pressure

Answer and Explanation

The Correct Answer is D

A) Stroke volume: Stroke volume is the amount of blood ejected from the heart with each contraction, and it's an essential parameter in assessing cardiac function. However, when titrating a nitroprusside infusion, the primary goal is to manage blood pressure rather than directly targeting stroke volume. Nitroprusside is primarily used as a vasodilator to lower blood pressure in hypertensive emergencies. While changes in blood pressure may indirectly affect stroke volume, blood pressure itself is the primary parameter for titration.

B) Cardiac output: Cardiac output, which is the volume of blood pumped by the heart per minute, may be affected by nitroprusside due to its vasodilatory effects. However, like stroke volume, cardiac output is not typically the primary parameter for titrating a nitroprusside infusion. Blood pressure is a more direct indicator of the drug's effect on vascular tone and perfusion pressure.

C) Urine output: Monitoring urine output is crucial for assessing renal function and fluid status, but it is not the primary parameter used to titrate a nitroprusside infusion. While nitroprusside may affect renal blood flow and urine output indirectly, blood pressure remains the immediate indicator of the drug's hemodynamic effects.

D) Blood pressure: Nitroprusside is a potent vasodilator commonly used to lower blood pressure in hypertensive emergencies. Therefore, the primary assessment parameter for titrating a nitroprusside infusion is blood pressure. The nurse should monitor the client's blood pressure frequently and adjust the infusion rate accordingly to achieve the desired therapeutic effect while avoiding hypotension or excessive lowering of blood pressure.

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Correct Answer is D

Explanation

D) Oxycodone causes central nervous system depression: Oxycodone is an opioid analgesic that acts centrally on the central nervous system (CNS) to relieve pain. One of the most significant side effects of opioids like oxycodone is respiratory depression, which occurs due to the suppression of the CNS, particularly in the brainstem respiratory centers. The brainstem regulates respiratory rate and rhythm, and when opioids depress these centers, it can lead to decreased respiratory drive, resulting in a decrease in respiratory rate. A respiratory rate of 8/min is significantly below the normal range, indicating respiratory depression caused by oxycodone.

A) Oxycodone inhibits prostaglandin synthesis: Oxycodone does not directly inhibit prostaglandin synthesis. Prostaglandins are lipid compounds with various physiological effects, including inflammation and pain modulation. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, inhibit prostaglandin synthesis by blocking cyclooxygenase enzymes. However, oxycodone primarily acts on opioid receptors in the CNS to relieve pain, rather than through prostaglandin inhibition.

B) Oxycodone promotes vasodilation of cranial arteries: While opioids can cause peripheral vasodilation, particularly in large doses, the primary mechanism of action of oxycodone is not through the promotion of vasodilation of cranial arteries. Vasodilation may occur as a side effect of opioid use, but it is not the primary cause of respiratory depression associated with oxycodone.

C) Oxycodone blocks the sodium channel suspending nerve conduction: This statement describes the mechanism of action of local anesthetics, such as lidocaine, which block sodium channels to inhibit nerve conduction. However, oxycodone is not a sodium channel blocker. Its analgesic effects result from binding to opioid receptors in the CNS, particularly mu-opioid receptors, rather than blocking sodium channels. Therefore, this option is not the pathophysiology for the respiratory rate of 8/min observed in the client receiving oxycodone.

A. Administer the insulin within 20 min of preparing it. B. Inject air into the vial to withdraw the short-acting insulin. C. Use two separate syringes to mix the insulin. D. Ensure the NPH insulin is drawn into the syringe first.

Correct Answer is B

Explanation

A) Administer the insulin within 20 min of preparing it: This statement is incorrect. Insulin should be administered immediately after mixing short-acting insulin with NPH insulin, but the 20-minute time frame is not accurate. It's crucial to follow the specific instruc’ions provided by the healthcare provider or the manufacturer for timing of administration.

B) Inject air into the vial to withdraw the short-acting insulin: This is the correct action. When mixing short-acting insulin with NPH insulin from two vials, the nurse should first inject air into the NPH insulin vial, withdraw the correct dose of air into the syringe, and then inject the air into the short-acting insulin vial. This prevents the creation of a vacuum in the vial and facilitates easier withdrawal of the medication.

C) Use two separate syringes to mix the insulin: Using two separate syringes is unnecessary and may increase the risk of dosing errors or contamination. Mixing insulin from two vials can be done using a single syringe by following proper aseptic technique and the correct sequence of steps.

D) Ensure the NPH insulin is drawn into the syringe first: This statement is incorrect. When mixing short-acting insulin with NPH insulin, the short-acting insulin should be drawn into the syringe first, followed by the NPH insulin. Drawing the NPH insulin first could lead to contamination of the short-acting insulin vial with NPH insulin, potentially altering its pharmacological properties.

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A nurse is preparing to titrate a continuous nitroprusside infusion for a client. The nurse should plan to titrate the infusion according to which of the following assessments?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has received oxycodone. The nurse notes that the client's respiratory rate is 8/min. The nurse should identify that which of the following is the pathophysiology for the client's respiratory rate?

Correct Answer is D

Explanation

A nurse is preparing to mix short-acting insulin with NPH insulin from two vials. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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