Deck 27: Drugs for Shock

Question 1

The young client has a history of multiple allergies, and the physician prescribed epinephrine (EpiPen) for prevention of anaphylactic shock. The client's mother says to the nurse, "I thought shock was about heart failure." What is the best response by the nurse?

A) "There are many kinds of shock: heart failure, nervous system damage, loss of blood, and respiratory failure."
B) "Heart failure is the most serious kind of shock; others include infection, kidney failure, and loss of blood."
C) "Allergic response is the most fatal type of shock; other types involve loss of blood, heart failure, and liver failure."
D) "There are many kinds of shock that also include infection, nervous system damage, and loss of blood."

Answer 1

"There are many kinds of shock that also include infection, nervous system damage, and loss of blood."

Question 2

The physician has prescribed phenylephrine (Neo -Synephrine) for an elderly client. What is an important nursing assessment prior to administration of this drug?

A) a history of narrow angle glaucoma
B) a history of human immunodeficiency virus (HIV) infection
C) a history of dizziness
D) a history of diabetes mellitus, type I

Answer 2

a history of narrow angle glaucoma

Question 3

The client is receiving normal serum albumin (Albuminar). What will be a priority outcome with this client?

A) The client will be normotensive, not hypertensive.
B) The client will be free of a rash.
C) The client will remain alert and oriented.
D) The client will experience adequate breathing patterns.

Answer 3

The client will experience adequate breathing patterns.

Question 4

The client will be receiving dopamine (Dopastat). What equipment will the nurse plan to obtain prior to infusion of this drug?

A) oxygen cannula
B) intravenous (IV) pump
C) pulse oximeter
D) sequential compression devices

Question 5

The client comes to the emergency department after suffering a bilateral traumatic amputation of his lower extremities. The physician orders normal serum albumin (Albuminar). The client goes into shock. What will the best nursing assessment of this client reveal?

A) B/P: 50/0 mm/Hg, P: 126, weak and thready, R: 14, and shallow.
B) B/P: 140/90 mm/Hg, P: 46, weak and irregular, R: 24, and shallow.
C) B/P: 80/20 mm/Hg, P: 122, weak and thready, R: 28, and shallow.
D) B/P: 130/88 mm/Hg, P: 90, bounding, R: 32, and shallow.

Question 6

The client is recovering from hypovolemic shock. The nurse hangs a bag of normal human serum albumin (Albutein) and educates the client about this fluid. The nurse evaluates that learning has occurred when the client makes which statement?

A) "It is a liquid that has electrolytes in it to pull water into my blood vessels."
B) "It is a protein that pulls water into my blood vessels."
C) "It is a super -concentrated salt solution that helps me conserve body fluid."
D) "It is a protein that causes my kidneys to conserve fluid."

Question 7

The client is receiving human serum albumin (Albutein) as treatment for shock. What is a priority assessment by the nurse?

A) Auscultate breath sounds for inspiratory stridor.
B) Auscultate breath sounds for crackles.
C) Auscultate breath sounds for hyper -resonance.
D) Auscultate for an absence of breath sounds in the lower lobes.

Question 8

The client is receiving norepinephrine (Levophed). When monitoring the client's blood pressure, the nurse notes a pressure of 230/120 mm/Hg. What is the priority nursing action?

A) Slow the rate of the infusion until the physician assesses the client.
B) Notify the physician.
C) Stop the infusion.
D) Assess the client for signs/symptoms of a stroke.

Question 9

The client 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?

A) Stabilization of fluid loss.
B) Vasoconstriction and increased blood pressure.
C) Urinary output of at least 50 mL/hour.
D) Increased cardiac output.

Question 10

The client comes to the emergency department with a severely infected pressure ulcer on the back. The client is in septic shock. The physician orders norepinephrine (Levophed) IV. Prioritize the nursing interventions for this client. Select all that apply.

A) Connect the client to a cardiac monitor and pulse oximeter.
B) Administer oxygen.
C) Maintain a patent airway.
D) Prepare for debridement of the pressure ulcer.
E) Assess the client's blood pressure.

Question 11

The client comes to the emergency department with a severe allergic reaction to peanuts, and is in serious respiratory distress. The client's spouse tells the nurse that the client has a known hypersensitivity to epinephrine (Adrenalin). What is the best response by the nurse?

A) "I'm not sure what we can use then. Do you know what has been used before with this allergic response?"
B) "This is a life -threatening situation; a prior hypersensitivity is not an absolute contraindication."
C) "I will let the physician know about this immediately; we will need to choose an alternative medication."
D) "This is a problem; we will need to use IV diphenhydramine (Benadryl)."

Question 12

The nurse works in a summer camp for children. One of the children says she was bitten by several wasps. The nurse plans to inject the child with epinephrine (EpiPen) if which symptoms are present? Select all that apply.

A) The child's skin feels cold and clammy.
B) The child's skin feels warm and dry.
C) The child is restless and confused.
D) The child is hyperactive and hyperverbal.
E) The child is thirsty.

Question 13

A graduate nurse abruptly discontinues the intravenous (IV) norepinephrine (Levophed) once it has infused into the client. What is the priority action of the more experienced nurse?

A) Administer oxygen via a rebreather mask.
B) Assess the client's blood pressure.
C) Notify the physician.
D) Obtain an oxygen saturation reading with a pulse oximeter.

Question 14

The physician orders dopamine (Dopastat) intravenous (IV) for the client in shock. What is a priority plan of the nurse with regard to administration of this drug?

A) Have epinephrine (Adrenalin) available in the room.
B) Have flumazenil (Romazicon) available in the room.
C) Have phentolamine (Regitine) available in the room.
D) Have naltrexone (Narcan) available in the room.

Question 15

The client is in shock with a blood pressure of 60/20 mm/Hg. 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?

A) "It is called a vasopressor and will help the kidneys increase and maintain blood pressure."
B) "Vasopressor drugs act on the renin -angiotension system and thus increase blood pressure."
C) "This drug is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller."
D) "This drug is a vasopressor and helps the heart beat more effectively, which will increase blood pressure."