A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?
Client reports decreased groin pain of 3 on a 1 to 10 scale.
The client tolerates a second dose of medication with no greater than 1+ peripheral edema.
Respirations are unlabored.
The client's blood pressure when arising from resting position is at premedication levels.
The Correct Answer is C
A. Decreased groin pain is not an indicator of therapeutic response specific to the effects of epinephrine in treating angioedema.
B. While tolerating a second dose of medication with minimal peripheral edema is positive, it does not directly reflect the immediate therapeutic effects of epinephrine.
C. Unlabored respirations indicate improved airway patency and reduced bronchoconstriction, which are key therapeutic outcomes of epinephrine administration in angioedema.
D. Blood pressure returning to premedication levels is beneficial but is not the most immediate indicator of epinephrine's therapeutic effect in managing angioedema.
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Correct Answer is B
Explanation
A. Respiratory alkalosis is characterized by a high pH and low PaCO2, which is not evident in this scenario where the pH is low and PaCO2 is elevated.
B. The low pH of 7.3 indicates acidemia, and the elevated PaCO2 of 50 mm Hg suggests respiratory acidosis, where the body is retaining carbon dioxide, leading to an increase in acidity.
C. Metabolic acidosis would present with a low pH and a normal or decreased PaCO2, which is not the case here since the PaCO2 is elevated.
D. Metabolic alkalosis would show a high pH and elevated HCO3 levels, which is not consistent with the given ABG results.
Correct Answer is D
Explanation
A. Furosemide is a diuretic and is not indicated in the acute management of anaphylaxis.
B. Methylprednisolone is a corticosteroid that may be used later to reduce inflammation but is not the first-line treatment in anaphylaxis.
C. Dobutamine is a medication used to treat heart failure and shock but does not address the acute allergic reaction.
D. Epinephrine is the first-line treatment for anaphylactic shock, as it acts quickly to reverse severe allergic reactions by causing vasoconstriction, bronchodilation, and inhibiting further release of mediators from mast cells.