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:
Establishing IV access and starting fluid replacement is important for maintaining hemodynamic stability, especially if there is significant blood loss. However, it is not the immediate priority in this scenario. Ensuring the neck is stabilized takes precedence to prevent potential spinal cord injury.

Choice B Reason:
Inserting a nasogastric tube is not a priority in the acute management of a trauma patient with a head injury. This procedure can be deferred until the patient's airway and cervical spine are secured and other life-threatening conditions are addressed.

Choice C Reason:
Keeping the neck stabilized is the priority action. In a trauma patient with a head injury, there is a high risk of cervical spine injury. Stabilizing the neck prevents further damage to the spinal cord, which could result in paralysis or other severe complications.

Choice D Reason:
Monitoring pulse and blood pressure frequently is essential for assessing the patient's hemodynamic status. However, it is not the immediate priority over stabilizing the cervical spine. Once the neck is stabilized, continuous monitoring of vital signs should follow.

Choice A Reason:
Suctioning the nose is not the first action to take. Suctioning can increase intracranial pressure and potentially cause further injury. It is important to first determine the nature of the drainage before taking any invasive actions.

Choice B Reason:
Notifying the physician is important, but it should be done after confirming the nature of the drainage. Testing the fluid for glucose can help determine if it is cerebrospinal fluid (CSF), which would indicate a serious complication requiring immediate medical attention.

Choice C Reason:
Testing the drainage for glucose is the correct first action. CSF contains glucose, so a positive test would confirm that the clear fluid is CSF. This is a critical step in diagnosing a CSF leak, which can occur with basal skull fractures and requires prompt intervention to prevent infection and other complications.

Choice D Reason:
Asking the client to blow their nose is contraindicated. Blowing the nose can increase intracranial pressure and exacerbate a CSF leak. It is important to avoid any actions that could worsen the condition until the nature of the drainage is confirmed.