The patient's family is asking questions about the medications used in the treatment for shock. The nurse explains that dopamine is one of the drugs being used and that it works:

(Select All that Apply.)

At high doses, to treat anaphylaxis.

At high doses, to increase cardiac output.

At low doses, to cause increased blood flow to the kidneys.

At low doses, to treat anaphylaxis.

To cause vasoconstriction and increase blood pressure.

Answer and Explanation

Correct Answer : B,C,E

A. At high doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis. Anaphylaxis is typically managed with medications such as epinephrine, antihistamines, and corticosteroids.

B. At high doses, to increase cardiac output: Dopamine is a medication commonly used in the treatment of shock, particularly in cases of hypotension. At higher doses, dopamine acts as a positive inotrope and increases cardiac contractility, thereby improving cardiac output and increasing blood pressure.

C. At low doses, to cause increased blood flow to the kidneys: At lower doses, dopamine primarily acts on dopaminergic receptors in the renal vasculature, leading to vasodilation of the renal blood vessels and increased renal perfusion. This can help improve renal blood flow and urine output, making it beneficial in cases of renal hypoperfusion or acute kidney injury.

D. At low doses, to treat anaphylaxis: Dopamine is not used to treat anaphylaxis at any dose. Anaphylaxis is managed with medications such as epinephrine, which acts on multiple receptors to reverse the systemic effects of the allergic reaction.

E. To cause vasoconstriction and increase blood pressure: Dopamine can also cause vasoconstriction, particularly at higher doses. This effect is mediated through its action on alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in systemic vascular resistance, which in turn helps increase blood pressure.

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Correct Answer is D

Explanation

A) Low-back pain:
Low-back pain is not a common manifestation of an allergic reaction to a blood transfusion. It may be associated with other conditions, such as musculoskeletal issues or renal complications, but it is not typically addressed by diphenhydramine administration during transfusion.

B) Fever:
While fever can occur as a manifestation of an adverse reaction to a blood transfusion, it is more commonly associated with non-allergic transfusion reactions such as transfusion-related acute lung injury (TRALI) or bacterial contamination of the blood product. Diphenhydramine is not specifically indicated for the prevention of fever during transfusion.

C) Dyspnea:
Dyspnea, or difficulty breathing, can occur as a manifestation of a severe allergic reaction or anaphylaxis during a blood transfusion. However, diphenhydramine alone may not be sufficient to prevent or treat severe respiratory symptoms associated with anaphylaxis. In such cases, prompt medical intervention and administration of epinephrine may be necessary. Diphenhydramine primarily targets histamine-mediated symptoms such as urticaria and itching.

D) Urticaria.
Urticaria, commonly known as hives, is a skin reaction characterized by raised, itchy welts that can occur as a result of an allergic or hypersensitivity reaction. During a blood transfusion, if the recipient's immune system reacts to foreign proteins in the transfused blood, it can lead to an allergic reaction characterized by symptoms such as urticaria, itching, flushing, and sometimes more severe reactions like anaphylaxis.
Diphenhydramine is an antihistamine medication that works by blocking the effects of histamine, a chemical released by the body during allergic reactions. By administering diphenhydramine before the blood transfusion, the nurse aims to prevent or minimize the occurrence of urticaria and other allergic symptoms.

A. Diabetes B. Hypertension C. Hyperthyroidism D. Heart disease E. Allergic rhinitis

Correct Answer is ["B","D"]

Explanation

A. Diabetes: Diabetes is not typically a contraindication for decongestant use. However, patients with diabetes should be cautious with decongestants that contain sugar or other ingredients that may affect blood glucose levels.

B. Hypertension: Decongestants can cause vasoconstriction, which may lead to an increase in blood pressure. Patients with hypertension should use decongestants cautiously and under the guidance of a healthcare provider to avoid exacerbating their condition.
C. Hyperthyroidism: While decongestants can stimulate the sympathetic nervous system and may exacerbate symptoms of hyperthyroidism such as tachycardia and palpitations, hyperthyroidism is not typically considered a contraindication for decongestant use. However, patients with hyperthyroidism should use decongestants cautiously and consult with their healthcare provider.

D. Heart disease: Decongestants can increase heart rate and blood pressure, potentially exacerbating symptoms in patients with underlying heart conditions such as coronary artery disease, heart failure, or arrhythmias. Patients with heart disease should use decongestants cautiously and consult with their healthcare provider before use.

E. Allergic rhinitis: Allergic rhinitis is not typically a contraindication for decongestant use. In fact, decongestants are often used to relieve nasal congestion associated with allergic rhinitis. However, patients with allergic rhinitis should use decongestants cautiously and follow the recommended dosage instructions.

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The patient's family is asking questions about the medications used in the treatment for shock. The nurse explains that dopamine is one of the drugs being used and that it works: (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose of diphenhydramine is to prevent which of the following manifestations of a transfusion reaction?

Correct Answer is D

Explanation

Decongestants should be used with caution in patients with which diagnoses? Select All that Apply.)

Correct Answer is ["B","D"]

Explanation

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A client presents with shock in the hospital, and has a history of a recent infection. What does the nurse suspect that this client is experiencing:

In reviewing a plan of care for a patient exhibiting the symptoms of anaphylaxis, which of the following medications would be avoided?

The patient's family is asking questions about the medications used in the treatment for shock. The nurse explains that dopamine is one of the drugs being used and that it works:

(Select All that Apply.)