Following 2 motor vehicle collision, an adult client is brought to the emergency department with a blood pressure of 72/50 mm Hg and a blood volume loss of approximately 40%. The nurse should plan care for this client based on which expected response to hemorrhaging?
Increased preload that results in generalized peripheral edema.
The lowered blood pressure results in a reduction of the heart rate.
Decreased preload that can lead to decreased cardiac output.
Increased peripheral resistance resulting from poor renal perfusion.
The Correct Answer is C
A) Increased preload that results in generalized peripheral edema:
This statement is incorrect. Decreased blood volume due to hemorrhage leads to decreased preload, not increased preload. Generalized peripheral edema is more commonly associated with conditions such as heart failure or kidney disease, where fluid retention leads to increased preload.
B) The lowered blood pressure results in a reduction of the heart rate:
While it's true that a decrease in blood pressure can trigger compensatory mechanisms such as an increase in heart rate (tachycardia), the specific response mentioned in this option is not entirely accurate. The primary compensatory response to hemorrhage-induced hypotension is typically an increase in heart rate, not a reduction.
C) Decreased preload that can lead to decreased cardiac output:
Correct. With decreased blood volume (preload), there is less blood returning to the heart during diastole. This leads to decreased ventricular filling and subsequently decreased stroke volume and cardiac output. Decreased cardiac output can contribute to hypotension and inadequate tissue perfusion.
D) Increased peripheral resistance resulting from poor renal perfusion:
While poor renal perfusion can trigger mechanisms to increase peripheral resistance (such as activation of the renin-angiotensin-aldosterone system), this option does not directly address the primary effect of decreased preload on cardiac output. Increased peripheral resistance alone does not adequately compensate for decreased preload to maintain cardiac output.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Benign prostatic hyperplasia (BPH) is a condition characterized by non-cancerous growth of the prostate gland, leading to its enlargement. This enlargement can contribute to urinary retention by obstructing the flow of urine through the urethra. Here's the breakdown of the explanation:
A) Abnormal growth results in loss of bladder muscle tone:
While BPH can lead to urinary symptoms such as urinary frequency, urgency, and nocturia, it does not directly cause loss of bladder muscle tone. Instead, the enlarged prostate gland obstructs the bladder outlet, making it difficult for urine to pass through the urethra.
B) Inflammation causes spasms of the gland:
Inflammation of the prostate gland, known as prostatitis, can cause symptoms such as pelvic pain, dysuria, and urinary frequency, but it is not typically associated with BPH. BPH is characterized by benign growth of the prostate tissue rather than inflammation and spasms.
C) The enlarged gland compresses the urethra:
Correct. The primary mechanism by which BPH causes urinary retention is by compressing the urethra, which obstructs the flow of urine from the bladder. As the prostate gland enlarges, it can constrict the urethra, leading to symptoms such as hesitancy, weak urinary stream, incomplete emptying, and urinary retention.
D) Nerve compression decreases the sensation that the bladder is full:
While compression of nerves in the pelvic region can contribute to urinary symptoms, such as decreased sensation of bladder fullness, it is not the primary mechanism by which BPH causes urinary retention. The compression of the urethra by the enlarged prostate gland is the main factor leading to urinary obstruction and retention.
Correct Answer is D
Explanation
Hemodialysis is a renal replacement therapy used to remove waste products and excess fluid from the blood when the kidneys are unable to perform this function adequately. The physiological processes involved in hemodialysis include:
A) Solute movement toward a solution with a higher concentration:
While solute movement occurs during hemodialysis, it is typically from a solution with a higher concentration to one with a lower concentration, rather than the opposite. This movement facilitates the removal of waste products and excess solutes from the bloodstream.
B) Water movement toward a solution with a lower solute concentration:
Correct. Osmosis is the movement of water across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration. In hemodialysis, water moves out of the bloodstream, across the semipermeable membrane of the dialyzer, and into the dialysate solution, which has a lower solute concentration. This process helps remove excess fluid from the body.
C) Blood cells and protein movement through the semipermeable membrane:
Blood cells and proteins are too large to pass through the pores of the semipermeable membrane in the dialyzer during hemodialysis. Therefore, the primary exchange occurs between smaller molecules such as urea, creatinine, electrolytes, and water.
D) Osmosis of water movement and diffusion of solute movement:
Correct. Hemodialysis involves both osmosis and diffusion. Osmosis refers to the movement of water across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration. Diffusion is the movement of solutes from an area of higher concentration to an area of lower concentration. Together, these processes facilitate the removal of waste products and excess fluid from the bloodstream during hemodialysis.
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