A nurse is providing care for a postoperative client. Which of the following manifestations should the nurse identify as indicating the development of postoperative shock?

The client has metabolic alkalosis and warm extremities

The client develops bradycardia and bradypnea

The client has hypotension and is confused

The client has hypertension and anuria

Answer and Explanation

The Correct Answer is C

A. The client has metabolic alkalosis and warm extremities: Metabolic alkalosis and warm extremities are not typically indicative of postoperative shock. Metabolic alkalosis may be caused by excessive vomiting or prolonged gastric suctioning, but it is not a hallmark sign of shock. Warm extremities may suggest adequate peripheral perfusion rather than impaired perfusion seen in shock.

B. The client develops bradycardia and bradypnea: Bradycardia (slow heart rate) and bradypnea (slow respiratory rate) may occur as compensatory mechanisms in certain types of shock, such as neurogenic shock. However, they are not specific indicators of postoperative shock. Tachycardia (rapid heart rate) and tachypnea (rapid respiratory rate) are more common findings in most types of shock, including postoperative shock.

C. The client has hypotension and is confused: Hypotension (low blood pressure) and confusion are classic signs of shock, including postoperative shock. Hypotension indicates inadequate perfusion of vital organs, while confusion may result from cerebral hypoperfusion. Altered mental status, such as confusion, is a significant neurological manifestation of shock.

D. The client has hypertension and anuria: Hypertension (high blood pressure) and anuria (decreased urine output) are not typical manifestations of postoperative shock. Hypertension may occur in certain conditions that can lead to shock, such as septic shock, during the compensatory phase. However, it is not a primary sign of shock. Anuria may occur in cases of severe hypovolemic shock but is not specific to postoperative shock.

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Correct Answer is ["A","B","D","E"]

Explanation

A. Hallucinations: As dementia progresses, especially in conditions like Alzheimer's disease, sensory perceptions can become distorted, leading to hallucinations, where the person perceives things that are not present.

B. Paranoia: Paranoia, or irrational suspicions and mistrust, often increases as dementia progresses. The person may become increasingly fearful or suspicious of others, even caregivers or family members.

C. Lethargy: While lethargy can be a symptom of dementia, it is more commonly associated with the earlier stages of the disorder when the person may experience apathy, lack of interest, and reduced energy levels. As the disease progresses, other behavioral changes like agitation or restlessness may become more prominent.

D. Impulsivity: Impulsivity, or acting without forethought or consideration of consequences, can increase as dementia progresses, particularly in certain types of dementia like frontotemporal dementia. This can manifest as impulsive behaviors such as excessive spending, inappropriate social behavior, or risky actions.

E. Disregard for caregiver's feelings: As dementia advances, the person's ability to empathize or recognize the feelings and needs of others may decline. They may become increasingly self-focused or unaware of the impact of their actions on caregivers, leading to behaviors that disregard or overlook the caregiver's feelings and well-being.

A. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow. B. The heart's electrical signals are rapid, chaotic, and irregular. C. An early electrical signal occurs before the expected sinoatrial (SA) node signal. D. The SA node sends an electrical signal greater than 100/min.

Correct Answer is B

Explanation

A. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow: This statement does not align with the manifestations of dizziness and palpitations in atrial fibrillation. A slow conduction through the AV node would typically manifest as bradycardia or heart block rather than rapid and irregular palpitations.

B. The heart's electrical signals are rapid, chaotic, and irregular: This is the correct answer. Atrial fibrillation is characterized by rapid, chaotic, and irregular electrical signals in the atria, leading to ineffective atrial contractions and an irregular ventricular response. The irregularity and rapidity of the heart rate can lead to symptoms such as palpitations and dizziness.

C. An early electrical signal occurs before the expected sinoatrial (SA) node signal: This statement does not accurately describe the mechanism of atrial fibrillation. Atrial fibrillation involves disorganized electrical activity in the atria, rather than a single early electrical signal.

D. The SA node sends an electrical signal greater than 100/min: While a heart rate greater than 100/min (tachycardia) is commonly associated with atrial fibrillation, this statement does not fully explain the manifestations of dizziness and palpitations. These symptoms are more directly related to the irregularity and chaotic nature of the heart's electrical signals in atrial fibrillation.

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A nurse is providing care for a postoperative client. Which of the following manifestations should the nurse identify as indicating the development of postoperative shock?

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