TCRN REVIEW - CHALLENGE QUESTIONS & ANSWERS 2024/25 A+ GRADE

TCRN REVIEW - CHALLENGE QUESTIONS & ANSWERS 2024/25 A+ GRADE Fluid resuscitation is undertaken for the patient in late, decompensatory hypovolemic shock. Which of the following findings indicates that this treatment is having its intended effect? An elevation in the: A. Pulse pressure B. Urinary output C. Respiratory rate D. Serum lactate levels - ANS-B A decrease in urinary output is associated with decompensatory hypovolemic shock, therefore an increase in this parameter is an indication of successful treatment. Pulse pressure, respiratory rate and serum lactate levels all increase with decompensatory shock, therefore an elevation in these levels is not associated with successful treatment. A patient receives 2 units of whole blood during the resuscitation phase of trauma. When documenting intake for the resuscitation, the trauma nurse will record what volume of fluid to account for those two units of while blood? A. 400 mL B. 500 mL C. 800 mL D. 1000 mL - ANS-D Which of the following factors is considered the most accurate indicator of successful resuscitation in the patient with hypovolemic shock? A. Base deficit B. Mental status C. Urinary output D. Blood pressure - ANS-A Tissue hypoxia causes the base deficit to decrease. Since tissue hypoxia is associated with inadequate fluid resuscitation, normalization of the base deficits associated with successful treatment. Alteration of mental status and an elevation in blood pressure are associated with successful treatment of hypovolemic shock but these parameters may be altered by many other factors including the use of beta-blocker medication, vasoconstriction associated with shock and use of alcohol or other illicit substances. Therefore, these indicators are less accurate than the base deficit. Similarly, an increase in urinary output is associated with successful resuscitation but may be altered by pre-existing renal failure, diabetes insipidus and other confounding factors. Therefore arterial base deficit is the most accurate indicator of adequate fluid resuscitation in the patient with hypovolemic shock. The trauma nurse knows that an elevation of which of the following laboratory values is associated with disseminated intravascular coagulation Continues...