A nurse is collecting data from a client who has isotonic fluid-volume deficit. Which of the following findings should the nurse expect?
Weak pulse
Distended neck veins
Bradycardia
Pitting Edema
The Correct Answer is A
A. Weak pulse: Isotonic fluid-volume deficit results in decreased blood volume, leading to reduced cardiac output and a weak, thready pulse.
B. Distended neck veins: This is associated with fluid volume excess, not deficit.
C. Bradycardia: Fluid deficit typically leads to tachycardia as the body compensates for decreased circulating volume.
D. Pitting edema: This is a sign of fluid overload rather than deficit.
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Related Questions
Correct Answer is C
Explanation
A. Urine output 20 mL/hr: A urine output of 20 mL/hr is on the low side but can still be expected in dehydration, as the body attempts to conserve water. Normal urine output is 30 mL/hr or more, so this could still be a sign of dehydration.
B. Sodium 142 mEq/L (136 to 145 mEq/L): This sodium level is within the normal range. Dehydration may cause sodium to be elevated if water loss is more significant than sodium loss, but a normal value does not indicate dehydration.
C. Cool skin: Cool skin is a typical finding in dehydration, particularly in severe cases, due to reduced peripheral circulation and vasoconstriction as the body tries to maintain core temperature and blood pressure.
D. Bradycardia: Dehydration usually causes tachycardia as a compensatory mechanism to maintain blood pressure and perfusion, not bradycardia.
Correct Answer is C
Explanation
A. Lactulose: Lactulose is used to treat hepatic encephalopathy by reducing ammonia levels, not for hyperkalemia.
B. Acetylcysteine: Acetylcysteine is used for acetaminophen overdose or as a mucolytic agent, not for hyperkalemia.
C. Sodium polystyrene (Kayexalate): Kayexalate is used to treat hyperkalemia by exchanging sodium for potassium in the intestines, promoting the elimination of potassium through the stool. This is the correct treatment for a potassium level of 6.8 mEq/L, which is dangerously high.
D. Triamterene: Triamterene is a potassium-sparing diuretic and would worsen hyperkalemia, not treat it.
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