The healthcare provider performs a paracentesis on a client with ascites and 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?
Increased heart rate
Increased urine production
Increased mental alertness
Increased breath sounds
The Correct Answer is A
Choice A rationale: This is because removing a large amount of fluid from the abdominal cavity can cause a sudden decrease in intra-abdominal pressure, which can lead to hypovolemia and hypotension. The body compensates by increasing the heart rate to maintain cardiac output and perfusion.
Choice B rationale: This is not directly related to paracentesis and may indicate other conditions.
Choice C rationale: This is not directly related to paracentesis and may indicate other conditions.
Choice D rationale: This is not directly related to paracentesis and may indicate other conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: A breast lump that increases in size before the menstrual period might be related to hormonal changes and is not necessarily indicative of a concerning issue.
Choice B rationale: Bilateral breast nodules that are tender with palpation might be related to benign conditions or hormonal changes.
Choice C rationale: A small, mobile, rubbery breast lump could suggest a benign condition like a fibroadenoma, which might not be as concerning.
Choice D rationale: A breast nodule that is 1 cm in size, nontender, and fixed could potentially raise concerns about malignancy and requires further evaluation.
Correct Answer is D
Explanation
Choice A rationale: This may indicate a different condition such as gastroenteritis rather than Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS).
Choice B rationale: This is more indicative of diabetic ketoacidosis (DKA) rather than HHNS.
Choice C rationale: A 72-year-old with a history of diabetes, elevated blood glucose, and complaints of thirst and frequent urination might have uncontrolled diabetes, but the absence of severe hyperglycemia and other symptoms specific to HHNS makes this choice less likely.
Choice D rationale: This fits the criteria for HHNS. The infection, missed medication, and extremely high blood glucose levels suggest the possibility of Hyperglycemic Hyperosmolar Nonketotic Syndrome.
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