Author Question: The home health nurse is caring for a 77-year-old male patient who has just been discharged from the ... (Read 74 times)

LaDunn · **on:** Jul 23, 2018

The home health nurse is caring for a 77-year-old male patient who has just been discharged from the hospital. The patient is receiving an infusion of dobutamine (Dobutrex) to treat congestive heart failure. What is the priority nursing assessment?

A) Capillary refill time and vital signs
B) Effectiveness of comfort measures
C) Dietary intake and hydration
D) Compliance with treatment plan

Question 2

The nurse is performing an admission assessment of a female teenage patient who has been experiencing nausea and vomiting. What question would be most important for the nurse to ask this patient?

A) What is the date of your last period?
B) What makes your nausea worse?
C) Have you also had diarrhea?
D) When did you last urinate?

ririgirl15 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
Feedback:
Dobutamine, although it acts at both receptor sites, has a slight preference for beta1-receptor sites. It is used in the treatment of heart failure because it can increase myocardial contractility without much change in rate and does not increase the oxygen demand of the cardiac muscle, an advantage over all of the other sympathomimetic drugs. Assessing capillary refill time and vital signs will allow the nurse to assess perfusion as an indicator of the effectiveness of the infusing drug. Dietary intake, compliance with treatment plan, and effectiveness of comfort measures are all important assessments but the priority assessment is perfusion.

Answer to Question 2

A
Feedback:
Most antiemetics are not appropriate for use by patients who are pregnant or lactating; therefore, it is most important for the nurse to determine whether the patient could be pregnant. Options B, C, and D are not as important as possible pregnancy.