Unit 4 - Adams 28 (Shock)

Examples of vasoconstrictors used to treat shock include all of the following except 1. propranolol (Inderal). 2. dobutamine (Dobutrex) 3. norepinephrine (Levophed). 4. phenylephrine (Neo-synephrine).

1

The patient is recovering from hypovolemic shock. The nurse hangs a bag of normal human serum albumin (Albutein) and educates the patient about this fluid. The nurse evaluates that learning has occurred when the patient makes which statement? 1. It is a protein that pulls water into my blood vessels. 2. It is a protein that causes my kidneys to conserve fluid. 3. It is a super-concentrated salt solution that helps me conserve body fluid. 4. It is a liquid that has electrolytes in it to pull water into my blood vessels.

1

The physician orders dopamine (Dopastat) intravenous (IV) for the patient in shock. What is a priority plan of the nurse with regard to administration of this drug? 1. Have phentolamine (Regitine) available in the room. 2. Have naltrexone (Revia) available in the room. 3. Have epinephrine (Adrenalin) available in the room. 4. Have flumazenil (Romazicon) available in the room.

1

The paramedics are transporting to the emergency department a patient who is experiencing shock. What will the nurse prepare in anticipation of the patients arrival? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Cardiac monitor 2. Pulse oximeter 3. Oxygen 4. Whole blood 5. Dextran 40

1,2

The nurse is concerned that a patient receiving dobutamine (Dobutrex) is experiencing adverse effects from the medication. What did the nurse assess in the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Palpitations 2. Drop in blood pressure 3. Cold extremities 4. Headache 5. Blurred vision

1,2,3

The patient will be receiving dopamine (Dopastat). What equipment will the nurse plan to obtain prior to infusion of this drug? 1. Oxygen cannula 2. Intravenous (IV) pump 3. Pulse oximeter 4. Sequential compression devices

2

The physician has prescribed phenylephrine (Neo-Synephrine) for an elderly patient. What is an important nursing assessment prior to administration of this drug? 1. A history of type 1 diabetes mellitus 2. A history of narrow angle glaucoma 3. A history of dizziness 4. A history of human immunodeficiency virus (HIV) infection

2

A graduate nurse abruptly discontinues the intravenous (IV) norepinephrine (Levarterenol) once it has infused into the patient. What is the priority action of the more experienced nurse? 1. Obtain an oxygen saturation reading with a pulse oximeter. 2. Notify the physician. 3. Assess the patients blood pressure. 4. Administer oxygen via a rebreather mask.

3

Colloids differ from crystalloids in that 1. they contain electrolytes. 2. they readily leave the blood and enter cells. 3. they are too large to cross membranes. 4. they promote urine output.

3

The patient comes to the emergency department after suffering a bilateral traumatic amputation of his lower extremities. The physician orders normal serum albumin (Albuminar). The patient goes into shock. What will the best nursing assessment of this patient reveal? 1. B/P: 140/90 mmHg, P: 46, weak and irregular, R: 24, and shallow. 2. B/P: 50/0 mmHg, P: 126, weak and thready, R: 14, and shallow. 3. B/P: 80/20 mmHg, P: 122, weak and thready, R: 28, and shallow. 4. B/P: 130/88 mmHg, P: 90, bounding, R: 32, and shallow.

3

The patient has experienced hypovolemic shock as a result of severe burns. The physician orders a low dose of dopamine (Inotropin). What is the best evaluation by the nurse? 1. Vasoconstriction and increased blood pressure 2. Stabilization of fluid loss 3. Urinary output of at least 50 mL/hour 4. Increased cardiac output

3

The patient is in shock with a blood pressure of 60/20 mmHg. The physician orders isoproterenol (Isuprel) intravenously (IV). The family is quite anxious and asks what that liquid is for. What is the best response of the nurse? 1. This drug is a vasopressor and helps the heart beat more effectively, which will increase blood pressure. 2. Vasopressor drugs act on the renin-angiotension system and thus increase blood pressure. 3. This drug is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller. 4. It is called a vasopressor and will help the kidneys increase and maintain blood pressure.

3

The patient is receiving normal serum albumin (Albuminar). What will be a priority outcome with this patient? 1. The patient will be normotensive, not hypertensive. 2. The patient will be free of a rash. 3. The patient will experience adequate breathing patterns. 4. The patient will remain alert and oriented.

3

A patient with cardiogenic shock would exhibit which of the following symptoms? 1. Bradycardia 2. Low temperature 3. Restlessness and anxiety 4. Tachycardia and low blood pressure

4

The mechanism of action of norepinephrine is to 1. cause increased blood flow. 2. increase heart rate. 3. decrease cardiac output. 4. produce vasoconstriction.

4

The patient is receiving human serum albumin (Albutein) as treatment for shock. What is a priority assessment by the nurse? 1. Auscultate breath sounds for hyper-resonance. 2. Auscultate for an absence of breath sounds in the lower lobes. 3. Auscultate breath sounds for inspiratory stridor. 4. Auscultate breath sounds for crackles.

4

The patient is receiving norepinephrine (Levophed). When monitoring the patients blood pressure, the nurse notes a pressure of 230/120 mmHg. What is the priority nursing action? 1. Assess the patient for signs/symptoms of a stroke. 2. Notify the physician. 3. Slow the rate of the infusion until the physician assesses the patient. 4. Stop the infusion.

4

What would be the expected first treatment of shock? 1. Start an intravenous line. 2. Assess level of consciousness. 3. Take the blood pressure. 4. Maintain the airway.

4