A client being treated for hypovolemic shock is prescribed a low ...

[oliviahorn72]

A client being treated for hypovolemic shock is prescribed a low dose of dopamine. Which outcome does the nurse anticipate for this client?
 
  A) Stabilization of fluid loss
  B) Increased cardiac output
  C) Vasoconstriction and increased blood pressure
  D) Urinary output of at least 30 mL/hour

Question 2

An older adult client is experiencing hypovolemic shock. Which is the priority intervention for this client?
 
  A) Administering analgesics for control of pain
  B) Assessing the cause of bleeding
  C) Providing replacement of volume
  D) Establishing invasive cardiac monitoring

[cupcake16]

Answer to Question 1

Answer: D

At low doses, dopamine stimulates dopaminergic receptors, especially in the kidneys, leading to vasodilation and an increased blood flow through the kidneys. Increased cardiac output occurs with high, not low, doses of dopamine when beta1-adrenergic receptors are stimulated. Vasoconstriction and increased blood pressure occur with high, not low, doses of dopamine when alpha-adrenergic receptors are stimulated. Dopamine does not prevent or stabilize fluid loss.

Answer to Question 2

Answer: D

With aging, there is a decrease in cardiac sympathetic activity. Older clients can have secondary volume depletion because of diuretics or malnutrition, and if prescribed a beta blocker, tachycardia may not occur as an early sign of hypovolemic shock. The older client will require early invasive monitoring in order to avoid excessive or inadequate volume restoration. This should be done early in the treatment phase. Replacement of volume would occur after invasive cardiac monitoring is established. Pain would be a consideration but would not be attended to as a first priority. Assessing the cause of bleeding would also occur after establishing invasive cardiac monitoring.

[oliviahorn72]

Gracias!

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