A client in shock has been started on dopamine. What assessment ...

[lilldybug07]

A client in shock has been started on dopamine. What assessment finding requires the nurse to communicate with the provider immediately?
 
  a. Blood pressure of 98/68 mm Hg
  b. Pedal pulses 1+/4+ bilaterally
  c. Report of chest heaviness
  d. Urine output of 32 mL/hr

Question 2

A client is being discharged home after a large myocardial infarction and subsequent coronary artery bypass grafting surgery. The client's sternal wound has not yet healed.
 
  What statement by the client most indicates a higher risk of developing sepsis after discharge?
 
  a.
  All my friends and neighbors are planning a party for me.
  b.
  I hope I can get my water turned back on when I get home.
  c.
  I am going to have my daughter scoop the cat litter box.
  d.
  My grandkids are so excited to have me coming home

[tkempin]

Answer to Question 1

ANS: C
Chest heaviness or pain indicates myocardial ischemia, a possible adverse effect of dopamine. While taking dopamine, the oxygen requirements of the heart are increased due to increased myocardial workload, and may cause ischemia. Without knowing the client's previous blood pressure or pedal pulses, there is not enough information to determine if these are an improvement or not. A urine output of 32 mL/hr is acceptable.

Answer to Question 2

ANS: B
All these statements indicate a potential for leading to infection once the client gets back home. A large party might include individuals who are themselves ill and contagious. Having litter boxes in the home can expose the client to microbes that can lead to infection. Small children often have upper respiratory infections and poor hand hygiene that spread germs. However, the most worrisome statement is the lack of running water for handwashing and general hygiene and cleaning purposes.

[lilldybug07]

Thank you

[tkempin]

Happy to help you