The nurse is administering norepinephrine (Levophed) to a client in shock. What is the most appropriate rationale for administering this medication?
1. To produce vasoconstriction
2. To cause bradycardia and reserve heart function
3. To increase cardiac output
4. To cause the heart's conduction system to work more effectively
Correct Answer: 1
Rationale 1: The body's ability to compensate during shock is limited, so vasoconstrictors are used to maintain blood pressure. This does cause increased cardiac output, but cardiotonic agents are used to increase cardiac output. Reflex bradycardia can result initially after vasoconstrictors are administered. Antidysrhythmics are not used to treat shock.
Rationale 2: To cause bradycardia and reserve heart function is incorrect because while reflex bradycardia initially can happen after administration, it is not the reason to administer this medication.
Rationale 3: To increase cardiac output is incorrect because this medication causes vasoconstriction, which in turn increases cardiac output.
Rationale 4: To cause the heart's conduction system to work more effectively is incorrect because antidysrhythmics are not used to treat shock.
Global Rationale: The body's ability to compensate during shock is limited, so vasoconstrictors are used to maintain blood pressure. This does cause increased cardiac output, but cardiotonic agents are used to increase cardiac output. Reflex bradycardia can result initially after vasoconstrictors are administered. Antidysrhythmics are not used to treat shock. To cause bradycardia and reserve heart function is incorrect because while reflex bradycardia initially can happen after administration, it is not the reason to administer this medication. To increase cardiac output is incorrect because this medication causes vasoconstriction, which in turn increases cardiac output. To cause the heart's conduction system to work more effectively is incorrect because antidysrhythmics are not used to treat shock.
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