Question

The nurse is caring for a patient exhibiting urticaria, pruritis, angioedema, and hypotension within 10 minutes after initiating and intravenous antibiotic infusion. Which of the following actions should the nurse do first? (Respond and provide the rationale for the answer. Please reference).

1. administer epinephrine intravenously
2. administer oxygen via nasal cannula
3. infuse normal saline rapidly
4. stop the antibiotic infusion

Rationale: ______________________________________________________________________________________________________________________________________________

A patient with myocardial infarction has developed cardiogenic shock. Hemodynamic monitoring reveals increased pulmonary wedge pressure (PCWP), increased central venous pressure (CVP), increased systemic vascular resistance (SVR), and decreased cardiac output (CO). The nurse would expect treatment of the patient to include administration of

1. Dopamine and dobutamine.
2. Lactated ringers and norepipherine.
3. Phenylephrine and hetastartch.
4. Milrinone lactate and nitoprusside.

Rationale: _____________________________________________________________________________________________________________________________________________

G is a 58 year old admitted to ICU with early stages of hypovolemic shock. Which of the following would be the best indicator of adequate fluid replacement?

1. diastolic blood pressure above 90mmHg
2. systolic blood pressure above 150mmHg
3. urine output of 15ml per hour for two hours
4. urine output of 220ml past four hours

Rationale: ______________________________________________________________________________________________________________________________________________

Answer 1

Rationale 1) administer epinephrine intravenously

Infuse normal saline rapidly

Stop antibiotics i.v.

It is a like anaphylactic shock so these intervention should be considered.

Rationale 2)Lactated ringers and norepipherine.

These intervention is to maintain cardiac output and other parameters.

Rationale 3)urine output of 220ml past four hours.

It is the best indicator for fluid replacement as it indicates the fluid level in body and all parameters are in normal range.

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