quick question - liver hemorrhage

  1. A question asked what are the signs of a complication of a percutaneous liver biopsy, so that's hemorrhage, and my choice was between 2 answers one was "HR 112, BP 100/60, RR 28" and the other was "Abdominal distention and discomfort" and I thought it was the distention because that BP doesn't look bad and the HR and RR could be from pain. I understand now it was the first answer though, and that's an early sign of shock and I shouldn't read into that more by thinking it could have been pain. My question though, is the 2nd answer correct too, but the first is just more correct? Thank you.
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  2. 5 Comments

  3. by   Castiela
    Yup. Joys of nclexy questions. You need the most right questions.
  4. by   WanderingWilder
    Maybe its because you would have changed vital signs before the abdomen distention and discomfort happens. So it should be the first sign to look for.
  5. by   direw0lf
    Quote from WanderingWilder
    Maybe its because you would have changed vital signs before the abdomen distention and discomfort happens. So it should be the first sign to look for.
    I noticed I think a lot about what I'd do in real life and it's not how it should necessarily be on test questions/NCLEX so I gotta get more disciplined! Like I am thinking more like about multitasking or something I noticed when it comes to how I answer questions.

    Thanks both for the replies.
  6. by   Scottishtape
    The reason the first one is correct is because when you're looking at hemorrhage, the combination of a low b/p and an elevated heart rate are classic signs.

    Yes, distension and abdominal discomfort can/will happen, but that'll be *after* you see a change in the vitals.
  7. by   ProperlySeasoned
    Agree - The abdomen can hold a tremendous amount of blood/fluid before patient's get really uncomfortable. That could be a normal BP for someone in really good shape, but look at the RR. 28? Yikes! Assuming your patient is an adult, that is way too high. Pro Tip: In the real world, RR in a non vented patient is the vital sign most likely to be "estimated" because doing it correctly requires accurate counting and timing. SNF/LTAC are notorious for everyone having a RR of 16. This questions also highlights the diagnostic importance of the RR in an otherwise stable patient.

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