A patient with active gastrointestinal bleeding is being monitored for complications. Which of the following signs indicates the patient is developing hypovolemic shock?

Elevated blood pressure

warm, flushed skin

Increased urine output

Increased heart rate

Answer and Explanation

The Correct Answer is D

A. Elevated blood pressure. Blood pressure typically drops in hypovolemic shock as blood volume decreases.

B. Warm, flushed skin. As hypovolemic shock progresses, skin becomes cool and clammy due to decreased blood flow and compensatory vasoconstriction.

C. Increased urine output. Hypovolemic shock leads to decreased urine output due to reduced renal perfusion.

D. Increased heart rate. An increased heart rate is an early compensatory response in hypovolemic shock as the body attempts to maintain cardiac output.

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Correct Answer is A

Explanation

A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.

B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.

C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.

D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.

A. Ensure that the client's urine output is at least 1ml/kg/hr B. Ensure potassium infusion is prepared with 5% dextrose solution C. Educate client regarding high-potassium food sources D. Repeat blood serum potassium E. Cardiac monitoring during infusion

Correct Answer is ["A","C","D","E"]

Explanation

A. Ensure that the client's urine output is at least 1 ml/kg/hr. Adequate urine output is essential before administering IV potassium to ensure the kidneys are functioning properly and can handle the increased potassium load, preventing hyperkalemia.

B. Ensure potassium infusion is prepared with 5% dextrose solution. While IV potassium can be mixed with normal saline or dextrose solutions, the specific diluent will depend on the clinical scenario. This isn't necessarily a standard requirement, so it may not be appropriate for all situations.

C. Educate the client regarding high-potassium foods. Education on high-potassium foods helps the client maintain potassium levels after treatment, reducing the need for future supplementation.

D. Repeat blood serum potassium levels. Rechecking potassium levels ensures the patient reaches a safe and therapeutic range and helps monitor for signs of overcorrection or continued hypokalemia.

E. Cardiac monitoring during infusion. Cardiac monitoring is critical, as hypokalemia and potassium replacement can affect heart rhythm and lead to arrhythmias.

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A patient with active gastrointestinal bleeding is being monitored for complications. Which of the following signs indicates the patient is developing hypovolemic shock?

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Naxlex Comprehensive Predictor Exams

A 45-year-old male patient present to the emergency department with a severe head injury following a car accident. His Glasgow Coma Scale (GCS) score is 8, and he shows signs of increased intracranial pressure (ICP). Which of the following interventions should be prioritized to manage his ICP?

Correct Answer is A

Explanation

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Correct Answer is ["A","C","D","E"]

Explanation

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