The nurse provides a client with a dose of the beta-selective adrenergic agonist isoproterenol. Which assessment finding indicates the medication is effective?
Constricted pupils
Warm, dry skin
Increased heart rate
Decreased urine output
The Correct Answer is C
A. Constricted pupils are not an expected response to isoproterenol, which generally causes dilation of the pupils due to sympathetic stimulation.
B. Warm, dry skin is not a direct indicator of the effectiveness of isoproterenol; it could result from various factors unrelated to the medication's action.
C. Increased heart rate indicates that isoproterenol, which is a beta-agonist, is effectively stimulating the beta-adrenergic receptors, leading to increased cardiac output and heart rate.
D. Decreased urine output is not a sign of effectiveness and could indicate adverse effects such as reduced renal perfusion.
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Correct Answer is C
Explanation
A. It has a peak effect of 4-6 hours is incorrect; short-acting insulin typically peaks between 2 to 3 hours after administration.
B. It should be given once daily in the evening is incorrect; short-acting insulin is usually administered before meals, not as a once-daily dose.
C. It starts to take effect within 30 minutes to 1 hour after administration is correct; this timing is critical for managing blood glucose levels during meals.
D. It has a duration of action of 24 hours is incorrect; short-acting insulin usually has a duration of about 3 to 6 hours.
Correct Answer is A
Explanation
A. An INR of 5.0 indicates a significantly increased risk of bleeding, and administering vitamin K is the appropriate antidote for reversing the effects of warfarin. This is a critical intervention to restore coagulation.
B. Increasing the dose of warfarin is inappropriate in this scenario because the INR is already elevated; it would further increase bleeding risk.
C. While heparin can be used for anticoagulation, it is not appropriate to administer it while the INR is dangerously high without reversing the warfarin first.
D. Continuing warfarin is unsafe at this INR level due to the high risk of bleeding; monitoring for symptoms without intervention is not adequate care.