Shock Drugs

Every question here, with the answer

1. A client develops hives, wheezing, and a blood pressure of 74/40 minutes after receiving an IV antibiotic. Which drug is the priority?

   1. Albuterol by nebulizer
   2. Dobutamine
   3. Epinephrine
   4. Norepinephrine

   Answer: Epinephrine

   Epinephrine is the most important drug for anaphylactic shock: it opens the airways and constricts blood vessels to raise blood pressure. Albuterol is added only if epinephrine does not fully open the airways, and the other drugs are used for cardiogenic shock.

2. A trauma client is in hypovolemic shock from active bleeding. What is the first priority?

   1. Give albuterol by nebulizer.
   2. Start a norepinephrine infusion.
   3. Start dobutamine to increase contractility.
   4. Stop the blood loss and give a blood transfusion as soon as possible.

   Answer: Stop the blood loss and give a blood transfusion as soon as possible.

   The first priority in hypovolemic shock is correcting the underlying cause, which means stopping the bleeding and transfusing. Vasopressors in hypovolemic shock are controversial, and hypovolemia must be corrected before norepinephrine.

3. A client with anaphylaxis is receiving albuterol by nebulizer. Which instructions should the nurse give? Select all that apply.

   1. Keep the nebulizer upright.
   2. Tilt the nebulizer on its side to breathe more easily.
   3. Tell the nurse if you feel chest pain or a racing heart.
   4. Expect the treatment to last about 10–15 minutes.
   5. Hold the mouthpiece between your teeth with your lips closed around it.

   Answer: Keep the nebulizer upright., Tell the nurse if you feel chest pain or a racing heart., Expect the treatment to last about 10–15 minutes., Hold the mouthpiece between your teeth with your lips closed around it.

   The client holds the mouthpiece between the teeth with lips closed, keeps the nebulizer upright, expects 10–15 minutes, and reports chest pain or rapid heart rate. Tilting the nebulizer contradicts the upright position.

4. A client with type 2 diabetes is on a norepinephrine infusion for shock. Which assessment should the nurse increase?

   1. Visual acuity checks
   2. Blood glucose checks
   3. Stool guaiac tests
   4. Hearing checks

   Answer: Blood glucose checks

   Norepinephrine may decrease sensitivity to insulin, so clients with diabetes may need more frequent glucose monitoring and higher antidiabetic doses. The other assessments are not linked to norepinephrine in the section.

5. A nurse is caring for a client receiving norepinephrine. Which actions are appropriate? Select all that apply.

   1. Correct hypovolemia before starting the infusion.
   2. Ignore mild pain at the IV site.
   3. Assess the IV site frequently.
   4. Stop the infusion abruptly once blood pressure is normal.
   5. Place the client on continuous cardiac monitoring.

   Answer: Correct hypovolemia before starting the infusion., Assess the IV site frequently., Place the client on continuous cardiac monitoring.

   Extravasation can cause tissue necrosis, hypovolemia must be corrected first, and cardiac monitoring is required because of arrhythmias. Abrupt discontinuation risks rebound hypotension, and IV site pain must be reported.

6. A client in anaphylactic shock has just had an IV line placed. What fluid order should the nurse expect?

   1. 1–2 L of an isotonic solution such as normal saline given rapidly
   2. Oral fluids only
   3. A slow infusion of dextrose to keep the vein open
   4. Fluid restriction to prevent pulmonary edema

   Answer: 1–2 L of an isotonic solution such as normal saline given rapidly

   In anaphylactic shock fluid shifts out of the vessels, so 1–2 L of isotonic solution such as normal saline is given rapidly as soon as an IV is established. Slow, restricted, or oral fluids will not restore intravascular volume.