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A nurse is caring for a client who is receiving IV fluid therapy. For which of the following findings should the nurse monitor as an adverse effect of the IV fluid therapy?

A.

Bradypnea

B.

Distended neck veins

C.

Weight loss

D.

Bradycardia

Answer and Explanation

The Correct Answer is B

A. Bradypnea. Slow respiratory rate is not a typical sign of fluid overload. In fact, fluid volume excess may lead to tachypnea or dyspnea as fluid accumulates in the lungs and impairs gas exchange.
B. Distended neck veins. Jugular vein distention is a classic sign of fluid volume overload. It reflects increased central venous pressure and is commonly seen in clients receiving excessive IV fluids or those with heart failure.
C. Weight loss. IV fluid therapy is intended to increase intravascular volume, and adverse effects are usually related to fluid retention, not loss. Weight gain, not weight loss, would indicate fluid overload.
D. Bradycardia. An increased, not decreased, heart rate (tachycardia) is typically seen with fluid volume excess or in response to fluid shifts. Bradycardia is not a common adverse effect of IV fluid therapy.


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Related Questions

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A,B"},"F":{"answers":"A,B"}}

Explanation

  • Fever: Fever is a nonspecific but common symptom found in all three conditions—epiglottitis, RSV, and streptococcal pharyngitis. However, it is more severe and abrupt in epiglottitis and low to moderate in RSV and strep throat. In this case, the toddler has had a persistent fever over 38°C, consistent with both RSV and strep.
  • Exudate on pharynx: Pharyngeal exudate is a hallmark sign of acute streptococcal pharyngitis, resulting from the inflammatory response to GABHS. It is not typical in RSV or epiglottitis, where erythema and swelling may occur but without purulent exudate.
  • Wheezing upon auscultation: Wheezing is a classic sign of RSV, a lower respiratory viral infection leading to bronchiolitis and airway obstruction. It is not a feature of epiglottitis or strep throat, which involve the upper airway and oropharynx, respectively.
  • Drooling: Drooling is strongly associated with epiglottitis, due to inflammation and swelling of the epiglottis which makes it painful and difficult to swallow. It is not typical in RSV or strep pharyngitis unless there is severe oral involvement or dehydration.
  • Hypoxia: Hypoxia may occur in both epiglottitis and RSV due to airway obstruction or inflammation compromising oxygenation. In epiglottitis, it results from upper airway narrowing; in RSV, from lower airway inflammation and mucus plugging. It is not common in uncomplicated streptococcal pharyngitis.
  • Tachypnea: Tachypnea is a sign of respiratory distress and is often present in both epiglottitis and RSV, as the body attempts to compensate for impaired gas exchange. It is not a primary feature of strep pharyngitis unless accompanied by systemic infection or high fever.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}

Explanation

  • Dry skin and lips: This is a very common side effect of isotretinoin due to its drying effects on sebaceous glands. It is expected and manageable with regular moisturizing and is not considered an emergency.
  • Increased appetite: Isotretinoin is not associated with increased appetite. Weight changes are not typical or concerning symptoms during therapy and do not warrant urgent provider notification.
  • Depression: Isotretinoin has been associated with mood changes including depression, suicidal thoughts, and other psychiatric effects. These can emerge suddenly and must be reported immediately for prompt evaluation and intervention to ensure safety.
  • Visual disturbances: Blurred vision or difficulty seeing, particularly at night, can indicate rare but serious complications such as increased intracranial pressure. Any change in vision during isotretinoin therapy requires immediate medical attention.
  • Productive cough: This is not commonly linked with isotretinoin therapy. Unless respiratory symptoms worsen or are accompanied by fever or systemic signs, a productive cough alone is not a reason to stop treatment or alert the provider urgently.

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