Fluid & Electrolyte Q 28 - Gyan Darpan : Learning Portal
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Tuesday 29 March 2022

Fluid & Electrolyte Q 28

Alexander has hypotonic FVE; which of the following findings would the nurse expect to assess in the patient?
    A. Poor skin turgor and increased thirst
    B. Weight gain and thirst
    C. Interstitial edema and hypertension
    D. Hypotension and pitting edema

Correct Answer: B. Weight gain and thirst

Weight gain and thirst are symptoms of hypotonic FVE; other symptoms include the excretion of dilute urine, non-pitting edema, dysrhythmias, and hyponatremia. Monitor for peripheral edema, pulmonary edema, or hepatomegaly. It is important to consider underlying cardiac dysfunction or renal failure and adjust volumes of administration accordingly. These patients might require a lower maintenance fluid rate than expected for their body weight.

Option A: Severe cases of dehydration might present with flaccid or tented skin; Eyeballs might also appear sunken back into orbital cavities. Classically find cool and clammy skin found in hypovolemic shock due to peripheral vasoconstriction causing hypoperfusion of skin, especially at the extremities (i.e., hands or feet)
Option C: Peripheral edema can be a sign of volume overload or third spacing of intravascular fluid. Appreciate a distended jugular vein in volume overload state; Can also be found in patients with congestive heart failure who are euvolemic but not pumping blood appropriately
Option D: Falling blood pressure is an ominous finding in the setting of tachycardia, indicating that the cardiovascular system can no longer compensate adequately for hypovolemia. Conversely, elevated blood pressures can be seen in hypervolemia.

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