A patient is brought to the emergency department for a ...

[Lisaclaire]

A patient is brought to the emergency department for a superficial stab wound to the forearm. Sutures are required, and a prescriber orders a local anesthetic with epinephrine.
 
  The nurse understands that the rationale for the use of epinephrine with a local anesthetic is to cause which of the following effects?
  a. Reduce anesthetic-induced nausea.
  b. Prolong anesthetic absorption.
  c. Reduce the pain of an injection.
  d. Prevent hypertension induced by the anesthetic.

Question 2

A nurse in the intensive care unit is preparing to administer dobutamine (Dobutrex). For which of the following patients would dobutamine (Dobutrex) most likely be indicated?
 
  a. The patient with hypertension
  b. The patient with tachycardia
  c. The patient with asthma
  d. The patient with heart failure

[mmj22343]

Answer to Question 1

ANS: B
Epinephrine prolongs anesthetic absorption, because it is an alpha1 agonist. It is frequently combined with a local anesthetic to delay anesthetic absorption.
Epinephrine does not act as an antiemetic, therefore it would not reduce anesthetic-induced nausea.
Epinephrine is not used to reduce the pain of an injection.
Anesthesia does not induce hypertension, therefore epinephrine is not indicated for use in such cases.

Answer to Question 2

ANS: D
Dobutamine is indicated for heart failure, because it helps alleviate symptoms by activating beta1 receptors on the heart, which increases myocardial contractility and thereby cardiac output.
Dobutamine is indicated for patients with hypotension to increase blood pressure, therefore it would be contraindicated in patients with hypertension.
Tachycardia is a side effect of dobutamine and is not among its therapeutic uses.
Dobutamine is not indicated for asthma, because it is a beta1-adrenergic drug.

[Lisaclaire]

Excellent

[bigsis44]

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