Missed PrepU Questions: Medication and I.V. Administration

dopamine sulfate adverse reactions

CNS: headache, anxiety. CV: hypotension, HTN, ventricular arrhythmias, atrial fibrillation, ectopic beats, tachycardia, angina, palpitations, conduction abnormalities, bradycardia, vasoconstriction. GI: nausea, vomiting. Metabolic: azotemia, hyperglycemia. Respiratory: dyspnea. Skin: necrosis and tissue sloughing with extravasation, piloerection.

The nurse is developing a teaching plan with a client who is newly diagnosed with Addison disease. Which topic is most important to include in the teaching plan?

Since Addison disease can be life-threatening, treatment often begins with the administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the client. A serious adverse effect of corticosteroids is hyperglycemia. Clients do not adjust their steroid dose based on dietary intake and exercise; insulin is adjusted based on diet and exercise. Addisonian crisis can occur secondary to hypoadrenocorticism, resulting in a crisis situation of acute hypotension, not increased blood pressure. Addison disease is a disease of inadequate adrenal hormone, and therefore, the client will have an inadequate response to stress. If the client takes more medication than prescribed, there can be a potential increase in potassium depletion, fluid retention, and hyperglycemia. Taking less medication than was prescribed can trigger an addisonian crisis state, which is a medical emergency manifested by signs of shock.

indications for dopamine hydrochloride

To treat shock and correct hemodynamic imbalances; to improve perfusion to vital organs; to increase cardiac output; to correct hypotension

A client has been on long-term prednisone therapy. What food source(s) should the nurse instruct the client to be sure to include in the diet to counteract the adverse effects of the drug? Select all that apply. a. Potassium b. carbohydrates c. saturated fat d. calcium e. vitamin D

a, d, e; Adverse effects of prednisone are weight gain, retention of sodium and fluids with hypertension and cushingoid features, a low serum albumin level, suppressed inflammatory processes with masked symptoms, and osteoporosis. A diet high in protein, potassium, calcium, and vitamin D is recommended. Carbohydrates would elevate glucose and further compromise a client's immune status. Saturated fat does not counteract the adverse effects of steroids such as prednisone.

A nurse regularly inspects a client's I.V. site to ensure patency and prevent extravasation during dopamine therapy. What is the treatment for dopamine extravasation? a. elevating the affected limb, applying warm compresses, and administering phentolamine as ordered b. elevating the affected limb, applying cold compresses, and administering hyaluronidase as ordered c. maintaining the limb in a dependent position and massaging it every 15 minutes d. asking the physician to make an incision and allowing the affected area to drain

a. If extravasation occurs with dopamine administration, the nurse should elevate the affected limb, apply warm compresses, and administer phentolamine as ordered. The nurse shouldn't massage the limb or apply cold compresses. Physicians don't generally order hyaluronidase for dopamine extravasation. An incision isn't required or appropriate to drain the affected area.

The student nurse asks why a client is receiving an I.V. of lactated Ringer's with potassium following an episode of diabetic ketoacidosis. What is the best response by the nurse? a. With acidosis, the intracellular potassium switches places with the plasma hydrogen ions to buffer the acidosis; the lactated Ringer's helps restore the bicarbonate reserves. b. Hypokalemia is associated with uncontrolled diabetes, and the lactated Ringer's is isotonic fluid replacement. c. In acidosis, the sodium moves into the cells to buffer the acid and displaces the potassium. The lactated Ringer's helps restore the alkaline pH. d. Lactated Ringer's will help lower the blood pH when hypokalemia is related to ketoacidosis.

a. In diabetic ketoacidosis, the cellular buffers will be activated. Potassium will move out of the cell and hydrogen will move inside the cells to lessen the impact on the plasma pH. Once the acidosis is corrected by bicarbonate injections and I.V. lactated Ringer's, potassium will move back into the cells, resulting in hypokalemia. Potassium levels will be monitored closely, and replacement will be initiated. Lactated Ringer's helps increase the blood pH and provides a source of bicarbonate replacement to replenish the base portion of the 1:20 acid-to-base relationship that helps maintain the blood at the pH of 7.35 to 7.45. Sodium does not switch with potassium in an acidotic state.

The nurse is administering furosemide I.V. push through a Groshong catheter. What is the appropriate action by the nurse after the medication is administered? a. flush with normal saline b. flush with heparin c. flush with normal saline and heparin d. flush with primary solution

a. The nurse should flush the line with normal saline after administering the medication. Due to the Groshong one-way valve, there is no need to follow the normal saline flush with a heparin flush or to flush with heparin. Flushing with the primary I.V. solution is not an appropriate answer because the line should always be flushed with a saline flush to ensure that the one-way valve opens and closes appropriately to prevent backflow.

The sudden onset of which sign indicates a potentially serious complication for the client receiving an IV infusion? a. pupillary constriction b. noisy respirations c. halitosis d. moist skin

b. fluid overloadA serious complication of IV therapy is fluid overload. Noisy respirations can develop as a result of pulmonary congestion. Additional symptoms of fluid overload include dyspnea, crackles, hypertension, bounding pulse, and distended neck veins.

A client is brought to the emergency department unconscious. An empty bottle of aspirin was found in the car, and a drug overdose is suspected. Which medication should the nurse have available for further emergency treatment? a. dextrose 50% b. sodium thiosulfate c. vitamin K d. activated charcoal powder

d. Activated charcoal powder is administered to absorb remaining particles of salicylate. Vitamin K is an antidote for warfarin sodium. Dextrose 50% is used to treat hypoglycemia. Sodium thiosulfate is an antidote for cyanide.

an enzyme that temporarily and reversibly depolymerizes hyaluronic acid; this creates microchannels in the interstitial matrix that allows fluids to flow through

hyaluronidase