Which of the following is a complicated manifestation of infective endocarditis?

Reduced blood pressure

Osler's nodes

Clear lung sound

Increased appetite

Answer and Explanation

The Correct Answer is B

Choice A Reason:
Reduced blood pressure is not a specific complication of infective endocarditis. While hypotension can occur in severe cases due to septic shock, it is not a hallmark of the disease. Infective endocarditis primarily affects the heart valves and can lead to embolic events, heart failure, and other complications.

Choice B Reason:
Osler's nodes are a classic sign of infective endocarditis. These are painful, red or purple, raised lesions found on the hands and feet. They are caused by immune complex deposition and are indicative of the systemic nature of the infection. Their presence can help in the clinical diagnosis of infective endocarditis.

Choice C Reason:
Clear lung sounds are not a complication of infective endocarditis. In fact, clear lung sounds would generally indicate that there is no pulmonary involvement or congestion. Complications of infective endocarditis are more likely to involve the heart, kidneys, and other organs through embolic events.

Choice D Reason:
Increased appetite is not associated with infective endocarditis. Patients with this condition often experience symptoms such as fever, fatigue, and weight loss due to the chronic infection. Increased appetite would be an unusual finding and not related to the disease process.

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Correct Answer is B

Explanation

Choice A Reason:
0.9% sodium chloride is an isotonic crystalloid solution often used for fluid resuscitation. However, it is not the preferred choice for burn patients because it lacks the necessary electrolytes to replace those lost through burn injuries. While it can be used if Lactated Ringer's is unavailable, it does not provide the same balanced electrolyte composition.

Choice B Reason:
Lactated Ringer's is the preferred fluid for initial resuscitation in burn patients. It is an isotonic crystalloid solution that closely mimics the body's plasma, providing essential electrolytes such as sodium, potassium, calcium, and lactate. The lactate in the solution acts as a buffer, helping to correct metabolic acidosis, which is common in burn patients. The Parkland formula, widely used for calculating fluid needs in burn patients, specifically recommends Lactated Ringer's for the first 24 hours.

Choice C Reason:
Dextrose 5% in water is a hypotonic solution that provides free water and calories but lacks electrolytes. It is not suitable for initial fluid resuscitation in burn patients because it does not address the electrolyte imbalances and large fluid shifts that occur after a burn injury. Using this solution could lead to further complications such as hyponatremia.

Choice D Reason:
Dextrose 5% in 0.9% sodium chloride is a hypertonic solution that provides both glucose and electrolytes. However, it is not typically used for initial burn resuscitation because the high glucose content can lead to hyperglycemia, which is detrimental to burn patients. Additionally, the solution's osmolarity can exacerbate fluid shifts and worsen edema.

Correct Answer is ["20.46"]

Explanation

Step 1: Convert the client's weight from pounds to kilograms.

150 pounds ÷ 2.2 = 68.18 kg

Result at each step = 68.18 kg

Step 2: Calculate the dose in mcg/min.

3 mcg/kg/min × 68.18 kg = 204.54 mcg/min

Result at each step = 204.54 mcg/min

Step 3: Convert the dose from mcg to mg.

204.54 mcg ÷ 1000 = 0.20454 mg/min

Result at each step = 0.20454 mg/min

Step 4: Calculate the infusion rate in mL/min.

0.20454 mg/min ÷ 600 mg × 1000 mL = 0.341 mL/min

Result at each step = 0.341 mL/min

Step 5: Convert the infusion rate to mL/hour.

0.341 mL/min × 60 min/hour = 20.46 mL/hour

Result at each step = 20.46 mL/hour

So, the infusion rate is 20.46 mL/hour.

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Which of the following is a complicated manifestation of infective endocarditis?

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Naxlex Comprehensive Predictor Exams

A nurse is monitoring the fluid replacement of a client who has sustained burns. The nurse should administer which of the following fluids in the first 24 hours following a burn injury?

Correct Answer is B

Explanation

An infusion at 3 mcg/kg/min. The drug is available as 600 mg in 1000 mL of fluid. The client weighs 150 pounds. Calculate. Do not round, if applicable.

Correct Answer is ["20.46"]

Explanation

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