Assessment of a client reveals a distended abdomen with some bulging of the flanks. Which test would be most accurate in confirming nurse's suspicions?
Abdominal x-ray
Shifting dullness
Fluid wave
Ultrasound
The Correct Answer is D
A. Abdominal x-ray: While it can show gas or bowel obstructions, it is less effective for confirming fluid presence.
B. Shifting dullness: This physical exam technique can indicate fluid but is less accurate than ultrasound.
C. Fluid wave: This physical exam can help suggest the presence of fluid, but it is also less reliable than imaging studies.
D. Ultrasound: An ultrasound is the most accurate and non-invasive way to confirm the presence of fluid, such as ascites, in the abdomen. It provides detailed imaging and confirmation without invasive procedures.
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Correct Answer is D
Explanation
A. Flat: A flat abdomen is level with no visible protrusions or concavities.
B. Protuberant: A protuberant abdomen appears swollen or distended, common in obesity or ascites.
C. Rounded: A rounded abdomen has a convex contour, commonly seen in children or adults with mild weight gain.
D. Scaphoid: A scaphoid abdomen appears sunken or concave, often showing visible lower ribs, suggesting malnutrition or dehydration.
Correct Answer is A
Explanation
A. Postural hypotension: Postural hypotension (a drop-in blood pressure when moving to a standing position) is a common sign of extracellular fluid volume deficit due to decreased circulating blood volume.
B. Dependent edema: This occurs with fluid volume excess, not deficit, due to fluid accumulation in tissues.
C. Bradycardia: Fluid volume deficit often leads to tachycardia as the body compensates for low blood volume, rather than a slow heart rate.
D. Distended neck veins: Distended neck veins suggest fluid overload, not a fluid deficit.