A patient who is in hypovolemic shock has the following clinical signs: BP 80/55 mmHg, heart rate 120 beats/min, and urine output of 20 mL/hr. After administering an IV fluid bolus, which of these signs is the best indication of improved perfusion?
Urine output increases to 35 mL/hr.
Heart rate decreases to 105 beats/min.
Systolic blood pressure increases to 85 mmHg.
Right atrial pressure decreases.
The Correct Answer is A
Choice A reason: An increase in urine output to 35 mL/hr is the best indication of improved perfusion. Urine output is a direct measure of kidney function and perfusion. When the kidneys receive adequate blood flow, they are able to produce urine. An increase in urine output indicates that the patient's kidneys are being perfused more effectively, which is a reliable sign of overall improved perfusion status.
Choice B reason: A decrease in heart rate to 105 beats/min is a positive sign, as it indicates a reduction in the stress response and an improvement in hemodynamic status. However, it is not as direct an indicator of improved perfusion as urine output. Heart rate can be influenced by many factors, and while a lower heart rate is generally a good sign, it does not specifically indicate improved organ perfusion.
Choice C reason: An increase in systolic blood pressure to 85 mmHg is an indication of improved hemodynamic stability, but it is not as sensitive a measure of perfusion as urine output. Blood pressure provides information about the pressure within the arteries but does not directly indicate how well the organs and tissues are being perfused.
Choice D reason: A decrease in right atrial pressure is not typically an indicator of improved perfusion. Right atrial pressure reflects the pressure in the right atrium of the heart, which can be influenced by various factors, including fluid status and cardiac function. It is not a direct measure of perfusion to vital organs and tissues.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The rehabilitative phase of burn care focuses on restoring function, improving cosmetic appearance, and achieving the best possible quality of life for the patient. This phase typically begins after the wound has healed and continues for months to years. The care priorities mentioned, such as wound care and nutritional support, indicate that the patient is still in a more active phase of treatment rather than the long-term rehabilitative phase.
Choice B reason: The acute phase of burn care starts after the initial resuscitation and continues until the wound is closed. During this phase, the primary focus is on wound care, nutritional support, and prevention of complications like infection. The goal is to promote healing, prevent infection, and address the patient's nutritional needs to support recovery. This phase aligns with the care priorities mentioned in the question.
Choice C reason: The emergent phase, also known as the resuscitative phase, begins at the time of injury and continues for the first 24-48 hours. The primary focus during this phase is on stabilizing the patient's condition, managing airway and breathing, fluid resuscitation, and addressing immediate life-threatening issues. The care priorities in the question indicate that the patient has moved beyond the initial resuscitative efforts.
Choice D reason: The immediate resuscitative phase overlaps with the emergent phase and focuses on providing immediate life-saving measures to stabilize the patient. This includes fluid resuscitation, airway management, and treating shock. The care priorities mentioned in the question suggest that the patient is beyond the initial resuscitative efforts and is in a more ongoing phase of treatment.
Correct Answer is A
Explanation
Choice A reason: Carbon monoxide poisoning can cause the skin, particularly the face, to appear cherry-red. This occurs because carbon monoxide binds with hemoglobin in the blood, forming carboxyhemoglobin, which gives the skin this distinct color. It is a critical condition that requires immediate intervention as carbon monoxide displaces oxygen in the blood, leading to hypoxia and potentially life-threatening complications.
Choice B reason: Smoke inhalation is a common issue in burn victims and can cause respiratory distress, coughing, and airway irritation. However, it does not typically cause the face to turn a cherry-red color. The primary concerns with smoke inhalation are airway obstruction and lung damage rather than changes in skin color.
Choice C reason: Uremic poisoning, or uremia, results from severe kidney dysfunction and the accumulation of waste products in the blood. Symptoms can include fatigue, confusion, and a metallic taste in the mouth, but it does not cause a cherry-red discoloration of the face.
Choice D reason: Acute anemic hypertension is not a recognized medical condition. Anemia can cause pallor or a pale appearance of the skin, while hypertension typically does not cause skin discoloration. Therefore, this choice is not relevant to the described symptoms.
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