A low-dose dopamine infusion is to be started for a client ...

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A low-dose dopamine infusion is to be started for a client diagnosed with hypovolemic shock. Which assessment finding indicates the drug is having the desired therapeutic effect?
 
  1. Nausea
  2. Increased urine output
  3. Increased blood pressure
  4. Ventricular tachycardia

Question 2

A client taking an MAO inhibitor for hypertension asks the nurse for medication to relieve nasal congestion. The nurse should know that phenylephrine will be a poor choice for this client because it might cause which condition?
 
  1. Tinnitus
  2. Hypokalemia
  3. Dizziness
  4. Hypertension

[irishcancer18]

Answer to Question 1

Correct Answer: 2
Rationale 1: Nausea is a common side effect, not a desired therapeutic effect.
Rationale 2: At low doses, dopamine selectively stimulates dopaminergic receptors, especially in the kidneys, causing increased urine output. At higher doses, dopamine stimulates beta-1 adrenergic receptors, causing the heart to beat more forcefully, thus increasing cardiac output. Also, at higher doses, dopamine stimulates alpha-1 adrenergic receptors, causing vasoconstriction and increased blood pressure.
Rationale 3: Increased blood pressure is not seen with a low-dose dopamine infusion.
Rationale 4: Ventricular tachycardia is not seen with a low-dose dopamine infusion.
Global Rationale: At low doses, dopamine selectively stimulates dopaminergic receptors, especially in the kidneys, causing increased urine output. At higher doses, dopamine stimulates beta-1 adrenergic receptors, causing the heart to beat more forcefully, thus increasing cardiac output. Also, at higher doses, dopamine stimulates alpha-1 adrenergic receptors, causing vasoconstriction and increased blood pressure. Nausea is a common side effect, not a desired therapeutic effect. Increased blood pressure and ventricular tachycardia are not seen with a low-dose dopamine infusion.

Answer to Question 2

Correct Answer: 4
Rationale 1: Phenylephrine does not cause tinnitus. If it is given within 21 days of an MAO inhibitor, hypertensive crisis can occur.
Rationale 2: Phenylephrine does not cause hypokalemia. If it is given within 21 days of an MAO inhibitor, hypertensive crisis can occur.
Rationale 3: Phenylephrine does not cause dizziness. If it is given within 21 days of an MAO inhibitor, hypertensive crisis can occur.
Rationale 4: Phenylephrine should not be administered within 21 days of an MAO inhibitor, or a hypertensive crisis could occur.
Global Rationale: Phenylephrine should not be administered within 21 days of an MAO inhibitor, or a hypertensive crisis could occur. Phenylephrine does not cause tinnitus, hypokalmia, or dizziness.

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[irishcancer18]

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