A patient with late-stage cirrhosis develops portal hypertension. All of the following are potential complications that can develop from this condition. Select all that apply.

Deep vein thrombosis.

Ascites.

Splenomegaly.

Esophageal varices.

Increased platelet levels.

Answer and Explanation

Correct Answer : B,C,D

Choice A reason: Deep vein thrombosis is a condition where blood clots form in the deep veins, usually in the legs. While it is a serious condition, it is not directly associated with portal hypertension in patients with late-stage cirrhosis. Portal hypertension primarily affects the liver and its associated blood vessels, leading to complications within the portal circulation system rather than systemic venous thrombosis.

Choice B reason: Ascites is the accumulation of fluid in the abdominal cavity, and it is a common complication of portal hypertension in patients with cirrhosis. Increased pressure in the portal vein leads to leakage of fluid into the abdominal cavity, causing distension and discomfort. Ascites can significantly impact the patient's quality of life and requires careful management.

Choice C reason: Splenomegaly, or enlargement of the spleen, is another potential complication of portal hypertension. The increased pressure in the portal vein can cause blood to back up into the spleen, leading to its enlargement. Splenomegaly can result in hypersplenism, where the spleen becomes overactive and destroys blood cells, contributing to anemia, thrombocytopenia, and leukopenia.

Choice D reason: Esophageal varices are dilated blood vessels in the esophagus that develop as a result of portal hypertension. The increased pressure in the portal vein causes blood to divert through collateral vessels, including those in the esophagus. These varices can rupture and cause life-threatening bleeding, making them a critical complication to monitor in patients with cirrhosis.

Choice E reason: Increased platelet levels are not typically seen in patients with portal hypertension. In fact, portal hypertension and cirrhosis often lead to thrombocytopenia, or low platelet levels, due to splenic sequestration and reduced platelet production. Thrombocytopenia is a more common finding in this patient population.

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Correct Answer is D

Explanation

Choice A reason: A heart rate of 56/min and a blood pressure of 110/70, while slightly lower than normal, may not require immediate intervention unless accompanied by other symptoms. Bradycardia (a slow heart rate) and this blood pressure reading can be within acceptable limits for some individuals, especially if they are asymptomatic.

Choice B reason: Mitral valve regurgitation with a thready peripheral pulse indicates a decrease in cardiac output, which can be concerning. However, it may not require immediate intervention unless the client shows signs of severe decompensation or other critical symptoms. Continuous monitoring and evaluation are essential, but immediate action might not be necessary.

Choice C reason: Chest pain with inspiration in a client with pericarditis can be a symptom of the condition itself, which involves inflammation of the pericardium. While pain management and monitoring are important, this symptom alone may not necessitate immediate intervention unless it is severe or accompanied by other alarming signs.

Choice D reason: The development of slurred speech in a client with a history of atrial fibrillation is a critical symptom that warrants immediate intervention. Slurred speech can be a sign of a stroke or transient ischemic attack (TIA), both of which require urgent medical attention. Immediate action is needed to evaluate and manage the client's condition to prevent further complications.

A. Inotropics. B. Antibiotics. C. Antidysrhythmics. D. Beta Blockers.

Correct Answer is B

Explanation

Choice A reason: Inotropic drugs are used to improve the strength of the heart's contractions and support cardiac output in cases of heart failure or cardiogenic shock. While they may be used as supportive therapy in septic shock to maintain blood pressure and perfusion, they are not the primary treatment.

Choice B reason: Antibiotics are the primary and most crucial therapy for managing septic shock. Septic shock is caused by a severe infection that leads to systemic inflammation and organ dysfunction. Prompt administration of broad-spectrum antibiotics is essential to target the underlying infection and prevent the progression of septic shock. Antibiotic therapy is initiated as soon as possible, often after obtaining blood cultures to identify the causative pathogen.

Choice C reason: Antidysrhythmic drugs are used to manage abnormal heart rhythms, such as atrial fibrillation or ventricular tachycardia. They are not specific to the treatment of septic shock but may be used if the patient develops arrhythmias as a complication of the shock state.

Choice D reason: Beta blockers are used to manage hypertension and certain types of arrhythmias by reducing the heart rate and the workload on the heart. They are not typically used in the acute management of septic shock and may even be contraindicated due to their potential to decrease cardiac output.

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