A nurse is monitoring a client who is receiving a continuous IV infusion of dopamine. Which of the following findings requires immediate intervention by the nurse?
Heart rate 105/min
Infiltration of the peripheral IV
Increased blood pressure
Occasional premature ventricular complexes (PVCs)
The Correct Answer is B
Rationale:
A. A heart rate of 105/min is slightly elevated, but it does not require immediate intervention unless the client is symptomatic or has other concerning signs.
B. Infiltration of the peripheral IV requires immediate intervention, as it can lead to tissue damage and prevent the medication from being effectively delivered. The nurse should stop the infusion, assess the site, and take appropriate action.
C. Increased blood pressure is a common effect of dopamine administration and does not necessarily require urgent intervention unless it becomes critically high or is associated with other adverse symptoms.
D. Occasional PVCs can occur during dopamine infusion and can be monitored unless they become frequent or symptomatic; they typically do not require immediate intervention.
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Correct Answer is B
Explanation
Rationale:
A. A decrease in the amount of gastric acid production: Alosetron is not used to decrease gastric acid production. This effect is more associated with medications such as proton pump inhibitors or H2 blockers.
B. A decrease in the frequency of defecation: Alosetron is used to treat irritable bowel syndrome with diarrhea (IBS-D) by reducing bowel movement frequency and improving stool consistency.
C. An increase in gastric motility: Alosetron works by decreasing intestinal motility, which helps reduce diarrhea, not by increasing it.
D. An increase in the absorption of water into the intestine: Alosetron does not specifically increase water absorption into the intestine. Its primary effect is slowing intestinal transit to reduce diarrhea.
Correct Answer is D
Explanation
Rationale:
A. Mostly cloudy: This option appears to be incorrectly stated. It does not pertain to a critical client assessment related to morphine administration.
B. Apical heart rate: Monitoring the heart rate is important, but respiratory depression is a more immediate and life-threatening concern with morphine administration, so it is not the first priority.
C. Blood pressure: Morphine can cause hypotension, but this is not as critical as respiratory depression, which must be assessed first in opioid administration.
D. Respiratory rate: The most critical assessment when administering morphine is the respiratory rate, as opioid medications like morphine can cause respiratory depression, which can be life-threatening if not addressed.
E. Level of consciousness: While important, changes in consciousness typically follow respiratory depression, so assessing the respiratory rate takes priority.