A graduate nurse abruptly discontinues the intravenous (IV) ...

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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 patient's blood pressure.
  4. Administer oxygen via a rebreather mask.

Question 2

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.

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Answer to Question 1

Correct Answer: 3
Rationale: Discontinuation of vasopressor therapy is always gradual, due to the possibility of rebound hypotension and undesirable cardiac effects, so the nurse should immediately assess the patient's blood pressure. The nurse will notify the physician, but the physician will want to know what the blood pressure is, so plan to assess blood pressure first. There is no indication to administer oxygen at this point. There is no indication to obtain an oxygen saturation percentage at this point.

Answer to Question 2

Correct Answer: 3
Rationale: In early shock, the body compensates for the fall in blood pressure by activating the sympathetic nervous system. The body's ability is limited, so sympathomimetic vasoconstrictors, known as vasopressors, have been used to stabilize blood pressure in shock patients. Vasopressors do not act on the kidneys. Vasopressors do not increase cardiac contractility. Vasopressors do not affect the renin-angiotension system.

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