The greatest threat to life in isotonic dehydration is:
Hypovolemic shock
Metabolic acidosis
Hypernatremia
Seizures
The Correct Answer is A
Choice A reason: Isotonic dehydration involves equal loss of water and electrolytes, reducing circulating volume. This can lead to hypovolemic shock, characterized by hypotension and organ hypoperfusion, risking multi-organ failure. In children, rapid fluid loss from diarrhea or vomiting makes this the greatest life-threatening complication, requiring urgent fluid resuscitation.
Choice B reason: Metabolic acidosis may occur in dehydration from bicarbonate loss (e.g., diarrhea), but it is less immediately life-threatening than hypovolemic shock. Acidosis causes compensatory tachypnea but rarely leads to rapid death. Shock’s impact on perfusion is the primary threat, making acidosis a secondary concern in isotonic dehydration.
Choice C reason: Hypernatremia occurs in hypertonic dehydration, not isotonic, where sodium levels remain normal. Isotonic dehydration’s primary risk is volume depletion, leading to hypovolemic shock. Hypernatremia causes neurological symptoms but is not the main threat, as isotonic dehydration maintains electrolyte balance, making this incorrect.
Choice D reason: Seizures may occur in dehydration from electrolyte imbalances like hyponatremia, but isotonic dehydration maintains normal sodium levels, reducing seizure risk. Hypovolemic shock, from significant volume loss, is the greatest threat, causing cardiovascular collapse, making seizures a less immediate concern in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Polyuria is not typical in nephrotic syndrome, which causes oliguria due to fluid retention from hypoalbuminemia and reduced oncotic pressure. Proteinuria leads to edema, not excessive urination. Polyuria occurs in conditions like diabetes insipidus, making this an incorrect expected finding for nephrotic syndrome’s pathophysiology.
Choice B reason: Periorbital edema is a hallmark of nephrotic syndrome, resulting from massive proteinuria and hypoalbuminemia, reducing plasma oncotic pressure. This causes fluid leakage into interstitial spaces, particularly around the eyes, due to loose tissue. It’s an expected finding, reflecting the disease’s impact on fluid balance in affected children.
Choice C reason: Orange-tinged urine is not associated with nephrotic syndrome. Proteinuria causes foamy urine, but color changes suggest hematuria or bilirubinuria, seen in other conditions like glomerulonephritis. Edema from fluid retention is more characteristic, making orange-tinged urine an incorrect expected manifestation in this condition.
Choice D reason: Hypertension may occur in nephrotic syndrome due to fluid overload or renin-angiotensin activation but is less common in minimal change disease, the most frequent pediatric form. Periorbital edema is a more consistent and early sign due to hypoalbuminemia, making it the primary expected manifestation over hypertension.
Correct Answer is B
Explanation
Choice A reason: A respiratory rate of 24/min is normal for a 3-year-old but does not specifically indicate rehydration success. Dehydration may cause tachypnea due to acidosis, but a normal rate is non-specific. Urine specific gravity better reflects fluid status, as it directly measures renal response to rehydration in diarrhea.
Choice B reason: Urine specific gravity of 1.015 indicates normal hydration, as kidneys produce appropriately concentrated urine after rehydration therapy corrects fluid loss in diarrhea. Values above 1.020 suggest persistent dehydration. This finding confirms effective restoration of fluid balance, making it the best indicator of successful oral rehydration in this child.
Choice C reason: Capillary refill greater than 3 seconds indicates poor perfusion, suggesting ongoing dehydration despite therapy. Effective rehydration restores perfusion, reducing refill time to less than 2 seconds. This finding suggests therapy failure, making it an incorrect indicator of successful oral rehydration in a child with diarrhea.
Choice D reason: A heart rate of 130/min suggests tachycardia, indicating persistent dehydration or stress in a 3-year-old, where normal rates are 80-120/min. Effective rehydration lowers heart rate by restoring volume. Urine specific gravity better confirms hydration status, making tachycardia an incorrect indicator of therapy success.
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