The nurse is caring for a client who has heart failure with an EF of 40%. The client has a BP of 170/67 with an HR of 60. He currently is in normal sinus rhythm and has an amber urine output of 45ml in the last 3 hours. Which medication would the nurse expect to give first?
Isosorbide PO
Nitroglycerin Drip
Dopamine drip
Normal Saline Bolus
The Correct Answer is D
D Normal saline bolus administration is indicated for hypovolemia or inadequate intravascular volume, which can lead to decreased cardiac output and hypotension. In this scenario, the client has an amber urine output of 45ml in the last 3 hours, indicating decreased urine output and potential hypovolemia. The elevated blood pressure (170/67 mmHg) suggests possible volume overload or fluid retention, but the decreased urine output raises concerns for inadequate intravascular volume. Therefore, administering a normal saline bolus may be the first priority to optimize intravascular volume and improve cardiac output.
A Isosorbide mononitrate is a vasodilator commonly used in the treatment of heart failure and angina. It helps reduce preload and afterload, thereby decreasing the workload on the heart. However, in this scenario, the client's blood pressure is elevated (170/67 mmHg), and there is no indication of acute decompensation or pulmonary congestion. Therefore, isosorbide PO may not be the first priority medication at this time.
B Nitroglycerin is a potent vasodilator commonly used to manage acute heart failure exacerbations and acute coronary syndromes. It helps reduce preload and afterload, improving cardiac output and relieving symptoms of heart failure. In this scenario, the client's blood pressure is elevated, but the heart rate is normal, and there are no signs of acute decompensation. Therefore, initiating a nitroglycerin drip may not be the first priority unless the client develops symptoms of acute decompensation or pulmonary congestion.
C Dopamine is a vasopressor medication that can be used to increase blood pressure and cardiac output in patients with hypotension or shock. However, in this scenario, the client's blood pressure is elevated (170/67 mmHg), and there is no evidence of hypotension. Therefore, initiating a dopamine drip may not be appropriate at this time and could potentially exacerbate hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Checking the left hand for pallor can help assess peripheral perfusion and determine if there is adequate blood flow distal to the arterial line insertion site. Pallor in the left hand could indicate decreased perfusion, which may contribute to the low-pressure alarm.
A. Re-zeroing the monitoring equipment may be necessary to ensure accurate pressure readings. However, it should not be the first action taken when the low-pressure alarm sounds. Before re-zeroing, the nurse should assess the patient's condition to ensure there are no immediate issues affecting arterial pressure.
C. Fast flushing the arterial line is not typically the first action to take when the low-pressure alarm sounds. Fast flushing may increase the risk of dislodging the catheter or causing air embolism if there is a problem with the line.
D. Assessing for dysrhythmias should be part of the overall assessment but may not be the first action taken in response to the alarm.
Correct Answer is []
Explanation
In respiratory acidosis, there is an accumulation of carbon dioxide (CO2) in the blood due to inadequate ventilation, leading to an increase in the partial pressure of arterial carbon dioxide (PaCO2) and a decrease in pH.
This is often caused by conditions that impair ventilation, such as airway obstruction, respiratory muscle weakness, lung diseases (e.g., chronic obstructive pulmonary disease, pneumonia), or central nervous system depression (e.g., drug overdose, head injury).
Management of respiratory acidosis include bronchodilators, sodium bicarbonate, adequate ventilation, and treatment of underlying causes.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today