4.17 Clinical Reasoning and Decision-Making Learning Activities

Test your knowledge and application.

Practice applying your knowledge regarding ANS neuroreceptors to the following client scenarios where a nurse must use clinical judgment for a solution:

1. A client begins a nicotine patch in an attempt to stop smoking. The client reports feelings of nausea, weakness, and a rapid heartbeat. What is the likely cause of these symptoms, and what is the nurse’s best response?
2. A client with benign prostatic hyperplasia (BPH) has a new order for tamsulosin.  He asks, “How will tamsulosin help me? I already take so many pills.
   1. What is the nurse’s best response?
   2. What does the nurse plan to monitor carefully, especially after administering the first dose of tamsulosin?
3. A client with asthma is taking albuterol to help when she feels increased shortness of breath.
   1. How will albuterol assist in her breathing?The client states, “After I take albuterol, it feels like my heart is racing.”
   2. What is the likely cause of this symptom?
   3. What is the nurse’s best response to the client’s concern?
4. A client with high blood pressure is prescribed propranolol.
   1. How will propranolol help to lower his blood pressure?
   2. What will the nurse assess before administering the propranolol?The nurse listens to the client’s lungs a few hours after administering propranolol and notices new wheezing.
   3. What  could be a potential cause of this new finding?
   4. What is the nurse’s next best response?
5. A client is prescribed metoprolol to help control his atrial fibrillation, an irregular heart rhythm.
   1. What will the nurse assess before administering the metoprolol?
   2. What findings would cause the nurse to call the provider before administering the metoprolol?Upon reassessment the next day, the nurse notices a new finding of edema in the client’s feet and lower legs.
   3. What could be a potential cause of this new finding?
   4. What is the nurse’s next best response?
6. A client with an acute episode of heart failure is admitted and is prescribed dobutamine.
   1. How will dobutamine improve the client’s condition?
   2. What will the nurse monitor carefully during administration?

Note: Answers to the Light Bulb Moment can be found in the “Answer Key” sections at the end of the book.