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A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?
- A. Dabigatran
- B. Levothyroxine
- C. Isoproterenol
- D. Furosemide
Correct Answer: D
Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic that works by causing increased urine production, leading to fluid loss and potential dehydration, which can result in orthostatic hypotension. This effect is more pronounced when the client changes positions quickly, such as getting out of bed.
A: Dabigatran is an anticoagulant and does not typically cause orthostatic hypotension.
B: Levothyroxine is a thyroid hormone replacement and does not usually cause orthostatic hypotension.
C: Isoproterenol is a beta-adrenergic agonist that can actually increase blood pressure, not cause orthostatic hypotension.
In summary, Furosemide is the correct answer because it is a diuretic that can lead to dehydration and orthostatic hypotension, while the other options do not typically cause this adverse effect.
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A nurse is caring for a client who has fluid volume excess and received furosemide 40 mg via intermittent IV bolus 1 hr ago. Which of the following findings indicates that the medication has been effective?
- A. Increased urinary output
- B. Increased respiratory rate
- C. Decreased blood pressure
- D. Increased pulse
Correct Answer: A
Rationale: The correct answer is A: Increased urinary output. Furosemide is a loop diuretic that promotes diuresis by inhibiting sodium and water reabsorption in the kidneys. Therefore, an increase in urinary output indicates that the medication has been effective in reducing fluid volume excess.
Incorrect Options:
B: Increased respiratory rate - Furosemide does not directly affect respiratory rate.
C: Decreased blood pressure - While furosemide may lead to decreased blood pressure as a side effect, it is not a direct indicator of the medication's effectiveness in this scenario.
D: Increased pulse - Furosemide may cause electrolyte imbalances that could impact pulse rate, but it is not a direct indicator of medication effectiveness in this context.
A nurse is preparing to administer dopamine 5 mcg/kg/min by continuous IV infusion to a client who weighs 220 lb. Available is 400 mg of dopamine in 250 mL of 0.9% sodium chloride. The nurse should set the IV pump to deliver how many mL/hr?
- A. 18.8 mL/hr
Correct Answer: A
Rationale: The correct answer is A: 18.8 mL/hr. To calculate the rate of dopamine infusion, we first need to convert the client's weight from pounds to kilograms by dividing it by 2.2 (220 lb / 2.2 = 100 kg). Next, we calculate the total daily dose of dopamine by multiplying the weight in kg by the ordered dose (100 kg x 5 mcg/kg/min x 60 min/hr x 24 hr/day = 720,000 mcg/day). Then, we convert the total daily dose to mL/hr by dividing it by the concentration of dopamine in the IV solution (720,000 mcg/day / 400 mg/250 mL x 1000 mcg/mg = 18.8 mL/hr). This calculation ensures the correct dosage is administered to the client. Other choices are incorrect as they do not follow the necessary conversion steps or include miscalculations in the dosage determination.
A nurse is providing teaching for a client who has a prescription for gentamicin. Which of the following should the nurse include as an adverse effect of this medication?
- A. Urinary frequency
- B. Constipation
- C. Hypertension
- D. Tinnitus
Correct Answer: D
Rationale: The correct answer is D: Tinnitus. Gentamicin is known to cause ototoxicity, including tinnitus, which is a ringing or buzzing sound in the ears. This adverse effect is important for the nurse to include in teaching to monitor for hearing changes. Urinary frequency (A), constipation (B), and hypertension (C) are not commonly associated with gentamicin use, so they are incorrect choices.
A nurse is preparing to administer ampicillin/sulbactam 15 g via intermittent IV bolus, Available is ampicillin-sulbactam 1.5 g in 0.9% sodium chloride 100 mL to infuse over 30 min. The nurse should set the IV infusion pump to deliver how many mL/h?
- A. 200 mL/h
Correct Answer: A
Rationale: The correct answer is A: 200 mL/h. To calculate the infusion rate, you first need to convert the total dose of ampicillin/sulbactam to mL. The concentration is 1.5 g in 100 mL, so 15 g would be in 1000 mL. The infusion time is 30 min, so you need to convert it to hours (30 min ÷ 60 = 0.5 hours). Next, divide the total volume (1000 mL) by the infusion time (0.5 hours) to get 2000 mL/h. Therefore, the nurse should set the IV pump to deliver 200 mL/h. Other choices are incorrect as they do not follow the correct calculations based on the given information.
A nurse is caring for a client who is receiving diazepam as sedation for an endoscopy, Which of the following antidotes should the nurse have on hand during the procedure?
- A. Naloxone
- B. Atropine
- C. Flumazenil
- D. Neostigmine
Correct Answer: C
Rationale: The correct answer is C: Flumazenil. Flumazenil is the antidote for benzodiazepines like diazepam, used for sedation. It works by competitively inhibiting benzodiazepine binding, reversing sedative effects. Naloxone (A) is for opioid overdose, Atropine (B) for bradycardia, and Neostigmine (D) for reversing neuromuscular blockade. No other choices provided. In summary, Flumazenil is the appropriate antidote for benzodiazepine overdose, making it the correct choice in this scenario.