A patient with acute pancreatitis is demonstrating signs of hypovolemic shock however has no obvious bleeding. The nurse realizes that these signs are because of
1. undiagnosed gastrointestinal ulcerations.
2. increased urine output.
3. damaged pancreatic tissue releasing vasodilation substances that cause fluid shifts.
4. pulmonary edema.
3
Rationale: Vasoactive substances, released from damaged pancreatic tissue, are responsible for vasodilation, decreased systemic vascular resistance, and increased permeability of endothelial linings of vessels. As vessels become more porous, intravascular fluids shift into other compartments and into the retroperitoneal cavity, causing hypovolemia, third spacing and hypovolemic shock. Even though hypovolemic shock can be caused by undiagnosed gastrointestinal ulcerations, there is not enough information to support this reason in the patient. An increase in urine output will not place a patient into hypovolemic shock in this situation. Pulmonary edema would be another symptom of third spacing of fluid being shifted from compartments.
You might also like to view...
A patient is experiencing poor perfusion in his right thorax as a result of suspected partially occluded arteries. Occlusion in which artery or arteries would cause this? Select all that apply
A) Aorta B) Internal mammary C) Subclavian D) Intercostal
Children in publicly funded school breakfast programs often have learning delays. These are not readily attributable to single causes
Research on learning delays has revealed that family literacy, measured by parental reading level and comprehension scores, is the most powerful predictor of delay in the primary grades. On the other hand, repeated exposure to eyes-on reading, in the company of a trusted non-parent adult, has been shown to over-ride family literacy as a predictor. No research, however, has studied institution of a reading-and-breakfast program, delivered five days a week before school, intended to over-ride the variable of family literacy. Given this problem statement, which of these purposes would be appropriate for the study? (Select all that apply.) a. The purpose of the study was to determine whether providing volunteer readers during school breakfasts for all kindergarten and first-grade children would result in fewer than anticipated learning delays. b. The purpose of the study was to determine the lived experience of children with learning delays, against the context of school and home, and to examine the children's peer relationships. c. The purpose of the study was to determine whether a buddy system of one sixth-grader, and one kindergartner or first-grader, who ate breakfast together and then read together for 20 minutes, was effective in decreasing the anticipated number learning delays. d. The purpose of the study was to experimentally determine what causes learning delays, by introducing various strategies already in place in community primary schools and measuring their effect, using basic research. e. The purpose of the study was to measure the effectiveness of using school computers, allowing children to visually scan a story concurrently read by a school teacher over the cafeteria microphone during school breakfast time, in decreasing the incidence and severity of learning delays.
The nurse is instructing a client on ways to reduce the transmission of tuberculosis. Which of the following should be included in these instructions?
1. The disease is transmitted by inhaling droplets exhaled by an infected person. 2. The disease is transmitted by not fully cooking foods. 3. The disease is transmitted by not washing hands. 4. The disease is transmitted by sexual contact.
An 80-year-old is seen in the emergency department for a fall. The client has bruises on the upper arms and appears depressed. The client is accompanied by a grandchild, who is unkempt, glassy-eyed, and whose breath smells of alcohol
Which of the following should be a priority with the nurse? A) Assess whether the older adult is safe in the home environment. B) Determine whether legal interventions are appropriate. C) Assess the client's degree of frailty and chronic health problems. D) Determine the mental capacity of the older adult.