The healthcare provider performs a paracentesis on a client with ascites and 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?
Increased heart rate
Increased urine production
Increased mental alertness
Increased breath sounds
The Correct Answer is A
Choice A rationale: This is because removing a large amount of fluid from the abdominal cavity can cause a sudden decrease in intra-abdominal pressure, which can lead to hypovolemia and hypotension. The body compensates by increasing the heart rate to maintain cardiac output and perfusion.
Choice B rationale: This is not directly related to paracentesis and may indicate other conditions.
Choice C rationale: This is not directly related to paracentesis and may indicate other conditions.
Choice D rationale: This is not directly related to paracentesis and may indicate other conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: This may indicate a different condition such as gastroenteritis rather than Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS).
Choice B rationale: This is more indicative of diabetic ketoacidosis (DKA) rather than HHNS.
Choice C rationale: A 72-year-old with a history of diabetes, elevated blood glucose, and complaints of thirst and frequent urination might have uncontrolled diabetes, but the absence of severe hyperglycemia and other symptoms specific to HHNS makes this choice less likely.
Choice D rationale: This fits the criteria for HHNS. The infection, missed medication, and extremely high blood glucose levels suggest the possibility of Hyperglycemic Hyperosmolar Nonketotic Syndrome.
Correct Answer is C
Explanation
Choice A rationale: Low blood pressure sensed by baroreceptors in the kidneys would stimulate the renin-angiotensin-aldosterone system, which regulates blood pressure and sodium balance.
Choice B rationale: Low osmolality sensed by osmoreceptors in the kidneys would
indicate that the body has excess water and needs to excrete it, which would inhibit ADH release.
Choice C rationale: ADH, or antidiuretic hormone, is a peptide hormone that regulates the water balance in the body. It is released from the posterior pituitary gland in response to signals from the hypothalamus. When the plasma osmolarity, or the concentration of solutes in the blood, is high, it means that the body is dehydrated and needs to conserve water. The osmoreceptors in the hypothalamus detect this change and stimulate the release of ADH, which acts on the kidneys to increase water
reabsorption and decrease urine output. This helps to lower the plasma osmolarity and restore the water balance.
Choice D rationale: High concentration of potassium sensed by chemoreceptors in the carotid body would affect the acid-base balance and respiratory rate, but not ADH
release.
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