You are caring for a patient with sepsis who has developed disseminated intravascular coagulation (DIC). Which assessments should you prioritize? (Select all that apply)
Urine output
White blood cell count
Level of consciousness
Weight
Oxygen saturation
Correct Answer : A,C,E
Choice A reason: Monitoring urine output is critical in sepsis-induced DIC, as it reflects renal perfusion and organ function. Decreased output may indicate hypoperfusion or acute kidney injury from microthrombi, common in DIC, making this a priority assessment to guide fluid and supportive therapy.
Choice B reason: White blood cell count is relevant in sepsis but less specific for DIC progression. It indicates infection severity but does not directly assess DIC’s coagulopathy or organ impact, making it a lower-priority assessment compared to organ function indicators.
Choice C reason: Level of consciousness is a priority, as DIC can cause cerebral microthrombi or hemorrhage, leading to neurological changes. Altered consciousness signals potential brain involvement or systemic hypoperfusion, necessitating immediate intervention, making this a critical assessment in sepsis with DIC.
Choice D reason: Weight assessment is not a priority in acute sepsis with DIC, as it does not directly reflect coagulopathy or organ dysfunction. Fluid shifts may occur, but urine output and other vital signs are more immediate indicators, making this non-essential.
Choice E reason: Oxygen saturation is crucial, as DIC can impair pulmonary perfusion through microthrombi, causing hypoxemia. Sepsis also increases oxygen demand, and low saturation indicates respiratory compromise, making this a priority assessment to ensure adequate oxygenation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Hemorrhagic stroke often causes headache and severe neurological deficits, not just sudden weakness. Ischemic stroke, from a clot, fits Isky’s sudden focal symptoms, so this is incorrect.
Choice B reason: Ischemic stroke, caused by arterial occlusion, presents with sudden weakness, numbness, and speech issues, as seen in Isky. Her risk factors (hypertension, diabetes, smoking) support this, making it correct.
Choice C reason: Transient ischemic attack resolves quickly, unlike Isky’s ongoing symptoms. Ischemic stroke causes persistent deficits, matching her presentation, so this is incorrect for the stroke type.
Choice D reason: Subarachnoid hemorrhage typically involves severe headache, not focal weakness. Ischemic stroke aligns with Isky’s sudden, unilateral symptoms, so this is incorrect for her condition.
Correct Answer is C
Explanation
Choice A reason: Insufficient mast cell numbers are not a primary cause of impaired healing in older adults. Mast cells contribute to inflammation, but chronic diseases like diabetes disrupt multiple healing pathways more significantly, making this incorrect.
Choice B reason: Circulatory impairment, such as atherosclerosis, can delay healing by limiting oxygen and nutrient delivery. However, it’s often a consequence of chronic illnesses like diabetes, which broadly affect healing, making this less primary than chronic conditions.
Choice C reason: Underlying chronic illnesses, like diabetes or cardiovascular disease, impair inflammation and wound healing in older adults by disrupting immune function, collagen deposition, and perfusion. These prevalent conditions directly impact healing, making this the correct cause.
Choice D reason: Complement and chemotaxis deficiencies occur in specific immunodeficiencies, not commonly in aging. Chronic illnesses like diabetes more consistently impair healing through systemic effects, making this a less likely primary cause.
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