Which medication is recognized by the Registered Nurse (RN) as a dilator for both arteries and veins?
Norepinephrine
Nitroglycerin
Nitroprusside sodium (Nitropress)
Lidocaine
The Correct Answer is C
Choice A rationale:
Norepinephrine is a potent vasoconstrictor, meaning it narrows blood vessels. It primarily acts on arteries, but it can also constrict veins to a lesser extent.
Its primary actions are to increase systemic vascular resistance and blood pressure.
It is often used in conditions such as shock to raise blood pressure and improve perfusion to vital organs.
It is not a vasodilator and would not be appropriate for a patient requiring dilation of both arteries and veins.
Choice B rationale:
Nitroglycerin is a vasodilator that primarily acts on veins. It relaxes the smooth muscle in the walls of veins, which allows them to dilate and hold more blood.
This reduces the amount of blood returning to the heart, which in turn lowers preload and reduces cardiac workload.
Nitroglycerin is often used to treat angina pectoris, a condition characterized by chest pain due to insufficient blood flow to the heart.
While it can also have some vasodilatory effects on arteries, its primary action is on veins.
Choice C rationale:
Nitroprusside sodium (Nitropress) is a potent vasodilator that acts on both arteries and veins. It directly relaxes smooth muscle in the blood vessel walls, leading to dilation.
It is a very powerful vasodilator and can rapidly lower blood pressure.
It is often used in hypertensive emergencies to quickly reduce blood pressure and improve cardiac function.
It is also used in conditions such as congestive heart failure and acute aortic dissection to reduce afterload and improve cardiac output.
Choice D rationale:
Lidocaine is a local anesthetic agent that is primarily used to block nerve conduction. It does not have any direct vasodilatory effects.
It is sometimes used in the treatment of cardiac arrhythmias, but its mechanism of action in this setting is not related to vasodilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Prednisolone is a corticosteroid that has anti-inflammatory and immunosuppressant effects. It does not have a direct effect on urine output.
While it may be used in some cases of head trauma to reduce inflammation, it would not be the first-line choice to address excessive urine output.
Prolonged use of prednisolone can have adverse effects such as fluid retention, weight gain, hypertension, and hyperglycemia.
Choice B rationale:
Corticotropin (ACTH) is a hormone that stimulates the adrenal glands to produce cortisol. Cortisol has a variety of effects, including increasing blood pressure and blood sugar levels.
It does not have a direct effect on urine output and would not be used to address this issue.
ACTH can have significant side effects, including fluid retention, electrolyte imbalances, and mood changes.
Choice C rationale:
Vasopressin is a hormone that regulates fluid balance in the body. It works by increasing water reabsorption in the kidneys, which can help to reduce urine output.
It is the most appropriate medication to administer to a client with excessive urine output following head trauma.
Vasopressin can be administered intravenously or subcutaneously. It is important to monitor the client's fluid intake and output closely when administering vasopressin, as it can lead to fluid overload if not used carefully.
Choice D rationale:
Calciferol is a form of vitamin D that helps to regulate calcium and phosphorus levels in the body. It does not have a direct effect on urine output.
It would not be used to address excessive urine output in a client with head trauma.
Excessive doses of calciferol can lead to hypercalcemia, which can cause kidney stones, bone pain, and other serious problems.
Correct Answer is A
Explanation
Choice A rationale:
Calcium gluconate is the antidote for magnesium sulfate toxicity. It directly counteracts the effects of magnesium on the neuromuscular system, cardiovascular system, and central nervous system. It is essential to have calcium gluconate readily available at the bedside of any client receiving magnesium sulfate, as toxicity can occur quickly and without warning.
Mechanism of action:
Calcium gluconate competes with magnesium for binding sites on cell membranes and proteins. It displaces magnesium from these sites, thereby restoring normal cellular function.
Calcium gluconate also enhances calcium influx into cells, which further counteracts the effects of magnesium. Indications for use in magnesium sulfate toxicity:
Respiratory depression (respiratory rate <12 breaths per minute) Loss of deep tendon reflexes
Seizures
Cardiac arrhythmias (including heart block and cardiac arrest) Hypotension (systolic blood pressure <90 mmHg)
Dosage and administration:
The typical dose of calcium gluconate for magnesium sulfate toxicity is 1 gram (10 mL of a 10% solution) given IV push over 3- 5 minutes.
This dose may be repeated as needed, depending on the severity of the toxicity and the client's response to treatment. Nursing considerations:
Monitor the client's vital signs, respiratory status, and deep tendon reflexes closely during magnesium sulfate infusion and after administration of calcium gluconate.
Have a crash cart and code equipment readily available in case of cardiac arrest. Document the administration of calcium gluconate and the client's response to treatment.
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