The client diagnosed with acute heart failure is prescribed an infusion of dopamine at a low dose. Which assessment parameter should the nurse use to best evaluate the effectiveness of this medication?

Urine output has increased from 30 mL to 50 mL per hour

Blood pressure decreased from 140/80 to 90/50

Heart rate has increased from 80 to 110 beats per minute

Client is awake, alert and oriented to time, place and person

Answer and Explanation

The Correct Answer is A

A.   Dopamine at low doses primarily increases renal perfusion, which can lead to improved urine output. An increase in urine output is a key indicator that the medication is effectively improving kidney function and blood flow. This is the most direct way to assess its effectiveness.
B.   A decrease in blood pressure is not an expected effect of low-dose dopamine, which should actually help improve perfusion and raise blood pressure.
C.   An increase in heart rate is more likely with higher doses of dopamine and is not an optimal indicator of the drug's effectiveness for acute heart failure.
D.   Client alertness is important but does not directly reflect the primary effects of dopamine on renal perfusion and cardiac output in acute heart failure.

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Correct Answer is D

Explanation

A. A value of 119 seconds would indicate a therapeutic or even elevated level of heparin, as it is much higher than the normal aPTT range.
B. A value of 98 seconds is still above the normal aPTT range, suggesting that the heparin level is therapeutic, or even too high, but not sub-therapeutic.
C. This is just slightly above the normal range and might be considered a therapeutic range for someone
on heparin, but it’s not sub-therapeutic.
D. This aPTT value is above the normal range but likely not high enough to indicate therapeutic heparin levels, which should typically be between 1.5 to 2.5 times the normal aPTT. A sub-therapeutic level could be indicated with a lower value.

A. Teach family members to assist with all ADLS once discharged B. Cluster activities to a time when the client has the most energy C. Provide alternating activity and rest periods D. Limit self-care activities until symptoms subside

Correct Answer is C

Explanation

A. While family support is important, encouraging complete assistance with all activities of daily living (ADLs) is not an ideal intervention. The goal is to maintain as much independence as possible, even if that means modifying or pacing activities. Encouraging complete dependency can lead to deconditioning and further loss of function.
B. Clustering activities is not the best intervention for this problem. Clustering involves grouping multiple tasks together at once, which can overwhelm the patient and lead to fatigue. Instead, the nurse should encourage pacing and spreading out activities to avoid overexertion, even if the patient has energy.
C. Providing alternating periods of activity and rest is a fundamental strategy in managing activity intolerance due to chronic heart failure. This approach helps balance the energy demands of daily activities with rest to prevent fatigue and overexertion. By alternating activity and rest, the patient can perform necessary tasks while minimizing strain on the heart.
D. The goal in chronic heart failure is to help the patient maintain independence and function as much as possible. Limiting self-care could lead to increased dependency and reduced quality of life. Activity modifications and appropriate pacing are better strategies.

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			Male: 14- 17.3 g/dL
Hematocrit	26%	24%	Female: 36%-48% Male: 42%-52%
Platelets	35,000mm3	20,000mm3	150,000- 450,000mm3
RBC	4.5 mm3	3mm3	Female: 4.01-5.51 million/mm3 Male: 4.51-

The client diagnosed with acute heart failure is prescribed an infusion of dopamine at a low dose. Which assessment parameter should the nurse use to best evaluate the effectiveness of this medication?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client receiving a heparin infusion for disseminated intravascular coagulation (DIC). Which of the following lab results would indicate a sub-therapeutic level? An activated partial thromboplastin time (aPTT) of :……. (normal value: 25-35 seconds)

Correct Answer is D

Explanation

The client problem of Activity Intolerance related to decrease in cardiac reserve is identified for a client with chronic heart failure. Which intervention should the nurse include in the plan of care related to this problem?

Correct Answer is C

Explanation

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