The nurse recognizes that which of the following clients present at the annual July 4th marathon is showing the most compelling signs of hyperthermia and the resulting heatstroke?
1. The 75-year-old who has forgot where the car is parked
2. The 16-year-old volunteer whose skin appears sunburned but dry
3. The 34-year-old who finished the race and is reporting leg cramps
4. The 55-year-old observer who complains of nausea and being thirsty
ANS: 2
Signs and symptoms of heatstroke include giddiness, confusion, delirium, excess thirst, nausea, muscle cramps, visual disturbances, and even incontinence. Vital signs reveal a body temperature sometimes as high as 45° C (113° F) with an increase in heart rate and lowering of blood pres-sure. The most important sign of heatstroke is hot, dry skin. Victims of heatstroke do not sweat because of severe electrolyte loss and hypothalamic malfunction. If the condition progresses, the client with heatstroke becomes unconscious with fixed, unreactive pupils. Permanent neurological damage occurs unless cooling measures are rapidly started.
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