Dopamine 3 mcg/kg/min. The client weighs 176 pounds. The drug is available as 500 mg in 250 mL. Round your answer.

Choice A Reason:
Monitoring the client for an elevated temperature is crucial because it can indicate an infection at the pin sites or other complications. Infections are a common risk with halo fixation devices due to the invasive nature of the pins.

Choice B Reason:
Ensuring the halo jacket is snug against the client's skin is incorrect. The halo jacket should fit properly but not be too tight, as this can cause skin breakdown and discomfort. There should be enough space to insert a flat hand between the vest and the skin.

Choice C Reason:
Providing range of motion to the client's neck is not appropriate for a client with a halo fixation device. The purpose of the halo is to immobilize the neck to allow for proper healing of cervical injuries. Any movement could jeopardize the stability of the injury.

Choice D Reason:
Removing the vest daily to inspect the client's skin integrity is incorrect. The halo vest should not be removed frequently as it is meant to provide continuous immobilization. Skin integrity can be monitored by checking the areas around the vest without removing it.

Choice A Reason:
Neurogenic shock occurs due to a disruption in the autonomic nervous system, often resulting from spinal cord injuries. This disruption leads to a loss of sympathetic tone, causing widespread vasodilation and a subsequent drop in blood pressure. The hallmark of neurogenic shock is hypotension with bradycardia, which differentiates it from other types of shock that typically present with tachycardia. The loss of vascular tone results in pooling of blood in the extremities, reducing venous return to the heart and decreasing cardiac output.

Choice B Reason:
Hypovolemic shock is caused by a significant loss of blood or fluids, leading to inadequate circulating volume. This can result from trauma, surgery, gastrointestinal bleeding, or severe dehydration. The primary mechanism is a reduction in preload, which decreases stroke volume and cardiac output. Clinical signs include tachycardia, hypotension, and cool, clammy skin. Rapid fluid resuscitation is critical to restore circulating volume and improve tissue perfusion.

Choice C Reason:
Metabolic shock is not a recognized type of shock in medical literature. The term might be confused with metabolic acidosis, which can occur secondary to shock but is not a primary cause. Metabolic acidosis results from the accumulation of lactic acid due to anaerobic metabolism when tissues are inadequately perfused. Therefore, metabolic shock is not considered a valid type of shock.

Choice D Reason:
Anaphylactic shock is a severe, life-threatening allergic reaction that leads to widespread vasodilation, increased capillary permeability, and bronchoconstriction. Common triggers include foods, insect stings, medications, and latex. Symptoms include hypotension, swelling, difficulty breathing, and hives. Immediate administration of epinephrine is crucial to counteract the severe allergic response and stabilize the patient.

Choice E Reason:
Septic shock results from a severe infection that leads to systemic inflammation and widespread vasodilation. The infection triggers an overwhelming immune response, causing damage to blood vessels and organs. Clinical features include fever, hypotension, tachycardia, and altered mental status. Early recognition and aggressive treatment with antibiotics and fluid resuscitation are essential to improve outcomes.

Choice F Reason:
Cardiogenic shock occurs when the heart fails to pump effectively, leading to inadequate tissue perfusion. Common causes include myocardial infarction, severe heart failure, and arrhythmias. Symptoms include hypotension, tachycardia, and signs of poor perfusion such as cool extremities and altered mental status. Treatment focuses on improving cardiac output through medications, mechanical support, or revascularization procedures.