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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?

A.

Elevated blood pressure

B.

warm, flushed skin

C.

Increased urine output

D.

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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Related Questions

Correct Answer is B

Explanation

A. Ciprofloxacin, Metronidazole, and Ranitidine: Ciprofloxacin and ranitidine are not recommended for H. pylori treatment. Ciprofloxacin is not typically used, and ranitidine is an H2 blocker, not a proton pump inhibitor.

B. Amoxicillin, Clarithromycin, and Omeprazole: This combination is a standard triple therapy for H. pylori infection. Amoxicillin and clarithromycin are antibiotics, and omeprazole (a proton pump inhibitor) reduces stomach acid to help eradicate the bacteria.

C. Metronidazole, Tetracycline, and Bismuth subsalicylate: This combination is part of quadruple therapy rather than triple therapy. Quadruple therapy is usually reserved for cases resistant to initial treatment.

D. Erythromycin, Amoxicillin, and Famotidine: Erythromycin is not part of standard triple therapy, and famotidine is an H2 blocker, not a proton pump inhibitor.

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A,B"}}

Explanation

Polyuria/Polydipsia:

  • Supports both DKA and HHS as both conditions typically exhibit severe dehydration and excessive thirst and urination.

Heart Rate (tachycardia):

  • Consistent with both DKA and HHS due to dehydration and fluid shifts, though heart rate alone does not differentiate the two.

Respirations (Kussmaul's):

  • Suggests DKA; deep, labored Kussmaul respirations typically help compensate for metabolic acidosis, which is characteristic of DKA.

Mental Status (confusion, lethargy):

  • More common in HHS, where very high glucose and osmolality levels often lead to more profound neurologic changes. Can also occur in DKA.

Serum Glucose >600 mg/dL and Serum Osmolality >320 mOsm/kg:

  • Consistent with both DKA and HHS, though more frequently seen in HHS given the higher osmolality. In DKA, serum glucose usually elevated but often lower than in HHS. Osmolality may be increased but not as high as in HHS.

Insidious onset (days to weeks):

  • Suggests HHS, as it often has a slower onset than DKA, which typically presents more acutely.

Infection as precipitating factor:

  • Could support either condition as infections can precipitate both DKA and HHS.

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