A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

Decrease in the urinary output from 50 mL to 30 mL per hour.

Increase in the heart rate from 88 to 110/min.

Decrease in the respiratory rate from 20 to 16/min.

Increase in the temperature from 37.5° C (99.5° F) to 38.6° C (101.5° F).

Answer and Explanation

The Correct Answer is B

A. A decrease in urinary output can be a sign of decreased blood volume but is less immediate than changes in heart rate.
B. An increase in the heart rate is a common compensatory response to hypovolemia as the body attempts to maintain adequate perfusion to vital organs.
C. A decrease in the respiratory rate is not typically associated with hypovolemic shock; rather, respiratory rate may increase due to compensatory mechanisms.
D. An increase in temperature is not a specific indicator of hypovolemic shock; it could be related to infection or inflammation rather than immediate hypovolemia.

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Correct Answer is D

Explanation

A. Frothy pink drainage is more characteristic of recent or active bleeding rather than an upper gastrointestinal bleed.
B. Greenish-yellow drainage typically indicates bile or gastric secretions rather than blood.
C. Dark amber drainage might suggest older, degraded blood but is less specific to an active upper GI bleed.
D. Coffee-ground drainage is indicative of older, partially digested blood and is expected in cases of upper gastrointestinal bleeding due to the breakdown of blood in the stomach.

A. Prednisone B. Montelukast C. Propranolol D. Theophylline

Correct Answer is C

Explanation

A. Prednisone is a corticosteroid commonly used to reduce inflammation and manage asthma exacerbations. Its use is appropriate for controlling severe symptoms.

B. Montelukast is a leukotriene receptor antagonist used for long-term control of asthma. It helps to prevent asthma symptoms and is appropriate for ongoing management.

C. Propranolol is a non-selective beta-blocker that can exacerbate asthma by blocking beta-2 receptors in the lungs, leading to bronchoconstriction. It is contraindicated in asthma patients and requires clarification.

D. Theophylline is a bronchodilator used for asthma management. It is appropriate for helping to relax and open the airways.

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A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

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