A 65-year-old female presents with confusion, headache, and muscle weakness. Her sodium level is 120 mEq/L. Which of the following interventions is most appropriate based on her condition?
Administer hypertonic saline and restrict water intake
Start fluid restriction and administer a loop diuretic
Administer isotonic saline and encourage oral fluid intake
Increase oral sodium intake and administer an antiemetic
The Correct Answer is A
A. Administering hypertonic saline (3% NaCl) is appropriate for treating severe hyponatremia, as it helps to raise sodium levels safely. Restricting water intake is also necessary to prevent further dilution of sodium.
B. Fluid restriction with a loop diuretic may not be effective in this scenario and can worsen the hyponatremia by causing further fluid loss without addressing the sodium levels.
C. Isotonic saline is not indicated for correcting severe hyponatremia, and encouraging oral fluid intake could exacerbate the condition.
D. Increasing oral sodium intake is not sufficient for immediate correction of severe hyponatremia and does not address the acute nature of the client’s symptoms.
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Correct Answer is C
Explanation
A. Obstructive shock occurs when blood flow is physically obstructed, such as in cases of pulmonary embolism or cardiac tamponade, which is not indicated here as the cause is blood loss.
B. Septic shock is related to infection and systemic inflammatory response, not directly caused by blood loss.
C. Hypovolemic shock is caused by a significant loss of blood volume, leading to decreased blood pressure, which directly relates to the client losing 800 mL of blood during surgery. This condition results in inadequate perfusion and oxygen delivery to tissues.
D. Neurogenic shock results from spinal cord injuries leading to vasodilation and bradycardia, which is not applicable to this scenario.
Correct Answer is B
Explanation
A. Increased systemic vascular resistance is typically associated with hypovolemic or cardiogenic shock, not distributive shock.
B. Distributive shock is characterized by systemic vasodilation, which leads to a decrease in systemic vascular resistance and results in inadequate tissue perfusion despite normal or increased cardiac output.
C. Loss of myocardial contractility is related to cardiogenic shock, not distributive shock.
D. Loss of blood volume is a characteristic of hypovolemic shock, whereas distributive shock occurs even when blood volume is normal due to vasodilation.