Editing Pharmacology – RN Practice Questions (section)

==Question 5==
A client in septic shock is receiving norepinephrine through a peripheral intravenous catheter in the forearm while central access is being obtained. The nurse notes blanching, coolness, and swelling around the insertion site. After stopping the infusion and disconnecting the tubing while leaving the catheter in place, which intervention should the nurse anticipate?
# Applying a warm compress and elevating the extremity only
# Infiltrating the site with phentolamine as ordered
# Flushing the catheter with 10 mL of normal saline to confirm patency
# Applying nitroglycerin ointment to the opposite extremity

'''Answer:''' 2 (B) Infiltrating the site with phentolamine as ordered.

''Rationale:'' Extravasation of a potent vasoconstrictor produces intense local vasoconstriction and can cause tissue necrosis. Phentolamine, an alpha-adrenergic blocker, is infiltrated into the affected area to reverse the vasoconstriction and restore perfusion. Option 1 alone is insufficient for a vasoconstrictor extravasation. Option 3 is contraindicated because flushing would push more drug into the tissue. Option 4 is wrong in site; topical nitroglycerin is sometimes used over the affected area, not the opposite extremity.