Question 1

A client in emergency department is being treated for hypovolemic shock after an MVA. It is estimated that he has lost 20% of his blood volume. What does the nurse identify as the most likely treatment?

A) Give blood products only to replace blood loss
B) Monitor infusions of vasoconstrictors
C) Give combination of colloid and crystalloids
D) Monitor infusions of beta adrenergic agonist

Give combination of colloid and crystalloids

Accepted Answer

Rationale 1. Blood products may not be given to someone with less than 30% blood loss.
Rationale 2. Vasoconstrictors are not the appropriate treatment for someone in hypovolemic shot, they need fluid volume replacements to improve blood pressure.
Rationale 3. A combination of colloid and crystalloid are used to provide volume expansion and to sustain blood pressure. Colloid and crystalloid infusions are often used when up to one-third of an adult's blood volume has been lost.
Rationale 4. Beta adrenergic agonist are not usually useful in hypovolemic shock.

Question 2

A client in septic shock has been transferred to the intensive care unit. She is started on a norepinephrine infusion. What is the primary action of this drug?&#10;A) Elevate blood pressure&#10;B) Increased urine output&#10;C) Decreased heart rate&#10;D) Decreased respiratory rate&#10;

Accepted Answer

The primary action of norepinephrine infusion in a client in septic shock is to elevate blood pressure.

Question 3

Students are completing a rotation in the intensive care unit. They have learned about Dopamine from the nurse educator. What do the students learn about dopamine when given in doses less than 3 ug/kg/min.?

A) Increases contractility
B) Increases cardiac output
C) Increases renal perfusion
D) Decreases cardiac output

Increases contractility

Accepted Answer

When students learn about dopamine from the nurse educator, they learn that when given in doses less than 3 ug/kg/min, dopamine increases renal perfusion.

Question 4

A student is writing her final exam in pharmacology. A question asks the student to identify drugs used in the treatment of shock. Which of the following does the student include in her Answer?&#10;A) Diltiazem&#10;B) Furosemide&#10;C) Norepinephrine&#10;D) Dobutamine&#10;E) Reteplase&#10;

Accepted Answer

Rationale 1. Diltiazem is a calcium channel blocker and is not used in shock 
Rationale 2. Furosemide is a diuretic and is not used in shock
Rationale 3. Norepinephrine is a vasoconstrictor and is useful in treating shock not caused by hypovolemia
Rationale 4. Dobutamine is a vasoactive adrenergic that increases the contractility and cardiac output
Rationale 5. Reteplase is a thrombolytic not used in the treatment of shock.

Question 5

A client is receiving hetastarch after abdominal surgery to treat signs of hypovolemia. The nurse would suspect an allergic response if which of the following signs were observed?&#10;A) Periorbital edema&#10;B) Increased blood pressure&#10;C) Tachycardia&#10;D) Urticaria&#10;E) Hematuria&#10;

Accepted Answer

The nurse would suspect an allergic response to hetastarch in a client if the following signs were observed: Periorbital edema, Tachycardia, and Urticaria. These symptoms are common indicators of an allergic reaction. Periorbital edema refers to swelling around the eyes, Tachycardia is a condition where the heart rate exceeds the normal resting rate, and Urticaria, also known as hives, is a kind of skin rash with red, raised, itchy bumps. Hematuria, or blood in urine, is not typically a sign of an allergic reaction, and increased blood pressure is not a specific sign of an allergic reaction.

Question 6

A nursing student is caring for a client who will be started on a dopamine infusion.As she begins her care planning what will she include in her teaching to the client?&#10;A) You will be placed on a continuous cardiac monitor&#10;B) Dopamine can cause ringing in the ear.&#10;C) Report any blood in your urine&#10;D) Report any pain or burning at the IV site&#10;E) Report any palpitations or headache&#10;

Accepted Answer

The nursing student should include the following in her teaching to the client: 
1. The client will be placed on a continuous cardiac monitor. This is to closely monitor the heart's activity as dopamine can affect heart rate and blood pressure.
2. Dopamine can potentially cause side effects such as palpitations or headaches. The client should be advised to report these symptoms immediately if they occur.
3. The client should also report any pain or burning at the IV site. This could indicate a problem with the infusion, such as infiltration or phlebitis.
4. While dopamine does not typically cause ringing in the ears or blood in the urine, any unusual or concerning symptoms should be reported to the healthcare team for further evaluation.

Question 7

A student nurse is working with an RN in the intensive care unit. They are caring for a client who has a dopamine infusion via peripheral line. The student asks why they are preparing the client for a central line insertion. What is the best response of the RN?

A) "Dopamine is not absorbed as well when it is infused peripherally."
B) "Dopamine can cause severe extravasation, it should be infused centrally."
C) "The central line is only being inserted so that her pressures can be monitored."
D) " All clients in ICU need central lines."

Unlock Deck

Unlock for access to all 7 flashcards in this deck.

Unlock Deck

k this deck

Accepted Answer

The best response of the RN would be: "Dopamine can cause severe extravasation, it should be infused centrally." This is because dopamine is a potent vasoconstrictor and if it infiltrates the surrounding tissue, it can cause tissue necrosis. Therefore, it is safer to infuse it through a central line to prevent this complication.

Deck 22: Pharmacotherapy of Shock