Nokea
A client is prescribed norepinephrine IV. Which of the following would be appropriate for the nurse to do?
- A. Administer the drug via a gravity infusion.
- B. Dilute the drug with sterile saline.
- C. Continuously monitor the client's blood pressure.
- D. Check the IV insertion site for leakage.
- E. Assess the client's urinary output hourly.
Correct Answer: C,D,E
Rationale: Norepinephrine requires an infusion pump, continuous blood pressure monitoring, IV site checks for leakage, and hourly urinary output assessment to ensure proper administration and effect.
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A nurse is preparing to administer a sympathomimetic drug. Which of the following might the nurse be preparing to give?
- A. Clonidine (Catapres)
- B. Isoproterenol (Isuprel)
- C. Midodrine (ProAmatine)
- D. Epinephrine (EpiPen)
- E. Reserpine (Serpalan)
Correct Answer: B,C,D
Rationale: Sympathomimetic drugs mimic the effects of the sympathetic nervous system, such as increasing heart rate and blood pressure. Isoproterenol, midodrine, and epinephrine are examples, while clonidine and reserpine have different mechanisms.
As part of the teaching plan for a client receiving midodrine, the nurse would instruct the client to report which of the following?
- A. Fine tremors
- B. Pounding headache
- C. Bradycardia
- D. Difficulty urinating
- E. Constipation
Correct Answer: B,C,D
Rationale: Midodrine can cause supine hypertension, bradycardia, and urinary difficulties, which should be reported to manage potential adverse effects.
The nurse administers isoproterenol (Isuprel) to a client. Which of the following would most likely occur?
- A. Decreased heart rate
- B. Increased use of glucose
- C. Decreased gastric motility
- D. Constriction of coronary blood vessels
- E. Wakefulness
Correct Answer: B,C,E
Rationale: Isoproterenol stimulates beta receptors, leading to increased heart rate, increased glucose metabolism, decreased gastric motility, dilation of coronary blood vessels, and wakefulness.
A nurse is caring for a client who has recently suffered an acute myocardial infarction. The nurse would closely monitor this client for which of the following that would suggest that the client is developing shock?
- A. Increased blood pressure
- B. Decreased urinary output
- C. Hypoxia
- D. Tachypnea
- E. Bradycardia
Correct Answer: B,C,D
Rationale: Signs of shock include decreased urinary output, hypoxia, and tachypnea due to inadequate tissue perfusion. Increased blood pressure and bradycardia are not typical signs of shock.
While assessing a client, the nurse observes hives and flushing. The client reports itching and a tightness in the throat. The nurse would identify which of the following nursing diagnoses?
- A. Risk for Allergy Response
- B. Ineffective Tissue Perfusion
- C. Decreased Cardiac Output
- D. Risk for Injury
Correct Answer: A
Rationale: Hives, flushing, itching, and throat tightness indicate an allergic reaction, making Risk for Allergy Response the appropriate nursing diagnosis.