An older patient with cardiogenic shock is cool and clammy and hemodynamic monitoring indicates a high systemic vascular resistance (SVR). Which intervention should the nurse anticipate doing next?
a. Increase the rate for the dopamine (Intropin) infusion.
b. Decrease the rate for the nitroglycerin (Tridil) infusion.
c. Increase the rate for the sodium nitroprusside (Nipride) infusion.
d. Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion.
ANS: C
Nitroprusside is an arterial vasodilator and will decrease the SVR and afterload, which will improve cardiac output. Changes in the D5/.9 NS and nitroglycerin infusions will not directly decrease SVR. Increasing the dopamine will tend to increase SVR.
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