Author Question: Ongoing fluid losses can overwhelm the child's ability to compensate, resulting in shock. What early ... (Read 137 times)

ssal · **on:** Jun 28, 2018

Ongoing fluid losses can overwhelm the child's ability to compensate, resulting in shock. What early clinical sign precedes shock?

a. Tachycardia
b. Slow respirations
c. Warm, flushed skin
d. Decreased blood pressure

Question 2

The presence of which pair of factors is a good predictor of a fluid deficit of at least 5 in an infant?

a. Weight loss and decreased heart rate
b. Capillary refill of less than 2 seconds and no tears
c. Increased skin elasticity and sunken anterior fontanel
d. Dry mucous membranes and generally ill appearance

mirabriestensky · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: A
Shock is preceded by tachycardia and signs of poor tissue perfusion and decreased pulse oximetry values. Respirations are increased as the child attempts to compensate. As a result of the poor peripheral circulation, the child has skin that is cool and mottled with decreased capillary refilling after blanching. In children, lowered blood pressure is a late sign and may accompany the onset of cardiovascular collapse.

Answer to Question 2

ANS: D
A good predictor of a fluid deficit of at least 5 is any two four factors: capillary refill of more than 2 seconds, absent tears, dry mucous membranes, and ill general appearance. Weight loss is associated with fluid deficit, but the degree needs to be quantified. Heart rate is usually elevated. Skin elasticity is decreased, not increased. The anterior fontanel is depressed.