quick question - liver hemorrhage

[direw0lf, BSN]

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.

[Castiela]

Yup. Joys of nclexy questions. You need the most right questions.

[WanderingWilder, ASN]

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.

[direw0lf, BSN]

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.

[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.

[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.