A client is admitted to the medical unit with fluid volume overload due to heart failure. Clinical manifestations of this problem are [Select all that apply]:

Choice A reason: Purplish streaks on the abdomen are also known as striae. They are caused by the thinning and weakening of the skin due to excess cortisol, a hormone that is elevated in Cushing syndrome. Striae are a common sign of Cushing syndrome, along with weight gain, moon face, and buffalo hump.

Choice B reason: Chronically low blood pressure is not associated with Cushing syndrome. Cushing syndrome can cause high blood pressure, due to the effects of cortisol on the cardiovascular system. Low blood pressure can be a sign of adrenal insufficiency, which is the opposite of Cushing syndrome.

Choice C reason: Bronzed appearance of the skin is not related to Cushing syndrome. Bronzed skin can be a sign of Addison's disease, which is a condition of low cortisol and low aldosterone. Addison's disease can cause hyperpigmentation of the skin, especially in the areas exposed to sun, such as the face, neck, and hands.

Choice D reason: Decreased axillary and pubic hair is also not related to Cushing syndrome. Cushing syndrome can cause increased hair growth, especially on the face, chest, and back. This is due to the androgenic effects of cortisol. Decreased hair growth can be a sign of hypothyroidism, which is a condition of low thyroid hormone.

Choice A reason: This statement is false. 3% Sodium Chloride is a hypertonic solution that can cause fluid overload, hypernatremia, and cellular dehydration. It is not indicated for a patient with nausea, vomiting, and Salmonella infection, who is likely to have fluid and electrolyte losses.

Choice B reason: This statement is false. Dextrose 10% in water is a hypotonic solution that can cause fluid shifts, hyponatremia, and cellular edema. It is not indicated for a patient with nausea, vomiting, and Salmonella infection, who is likely to have fluid and electrolyte losses.

Choice C reason: This statement is true. 0.9% Sodium Chloride with 40 mEq Potassium (KCl) is an isotonic solution that can maintain fluid and electrolyte balance. It is indicated for a patient with nausea, vomiting, and Salmonella infection, who is likely to have fluid and electrolyte losses, especially sodium and potassium.

Choice D reason: This statement is false. Lactated Ringers is an isotonic solution that can maintain fluid and electrolyte balance, but it also contains lactate, which can be converted to bicarbonate in the liver. It is not indicated for a patient with nausea, vomiting, and Salmonella infection, who may have metabolic acidosis due to diarrhea and lactate accumulation.