Discuss AACN CCRN-Adult Exam Topic 2 Question 15

A patient is admitted following a motor vehicle crash. A fluid challenge is initiated immediately after assessing a BP of 80/palpable. Fifteen minutes later,

vital signs are as follows:

BP 86/50

HR 150

RR 36

The most appropriate action should be to

Aadminister a vasopressor.

Badminister a second fluid challenge.

Crequest a CT scan of the chest.

Drequest an abdominal ultrasound.

Suggested Answer: B

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30 comments · newest first

Caitlin 7 months ago

D is not relevant. We need to focus on the immediate vitals.

Gracia 8 months ago

C seems unnecessary right now. We need to stabilize first.

Lucina 8 months ago

I feel like A is risky without more fluids first.

Micaela 8 months ago

I’m leaning towards B. Another fluid challenge might be necessary.

Nickolas 8 months ago

I think A is the best choice. Vasopressors can help stabilize BP.

Cherry 8 months ago

I’m surprised they didn’t do a CT scan right away!

Gilma 8 months ago

A second fluid challenge is definitely the way to go here!

Queen 9 months ago

Totally agree, BP is still low after the first challenge!

Arminda 9 months ago

Looks like they need more fluids, so B seems right.

Audria 9 months ago

I'd go with the second fluid challenge. Gotta keep that fluid flowing until the patient's vitals stabilize.

Pedro 9 months ago

Haha, an abdominal ultrasound? What, are we trying to find the patient's lost car keys or something?

Dorothy 9 months ago

Hmm, I'm not sure. The CT scan might be a good idea to check for any internal injuries. Better safe than sorry, right?

Patria 9 months ago

Hmm, this is a tricky one. I'm not sure if a vasopressor or another fluid challenge is the best approach. Maybe I should ask the professor for some clarification before making a decision.

Taryn 10 months ago

Definitely a second fluid challenge. Gotta get that BP up before even thinking about imaging or vasopressors.

Annita 10 months ago

I'd go with the vasopressor. The BP is still too low, and the tachycardia and tachypnea suggest the patient needs more than just fluids.

Danica 10 months ago

The patient's vital signs indicate hypovolemic shock, so a second fluid challenge is the most appropriate action.

Louvenia 10 months ago

Wait, why not just go straight to a vasopressor?

Geraldo 10 months ago

I agree with B. We need to address the hypovolemia.

Adelaide 11 months ago

I feel pretty confident about this one. The patient is clearly in shock, and with the low BP and tachycardia, a second fluid challenge is the way to go. I'd start there and see if that helps stabilize the patient.

Kent 11 months ago

Okay, let's think this through. The patient's vitals are still pretty unstable, so I don't think a CT or ultrasound is the right call right now. I'm leaning towards option B or A, but I'll need to weigh the risks and benefits of each.

Willard 11 months ago

I'm a bit confused here. The patient's BP is still pretty low, but the tachycardia and tachypnea suggest they might be going into distributive shock. Maybe a vasopressor would be better to support their blood pressure?

Kathrine 11 months ago

Hmm, this seems like a classic case of hypovolemic shock. I'd go with option B and administer a second fluid challenge to try to stabilize the patient's vitals.

Corinne 6 months ago

↳ replying to Kathrine

Let's not forget about imaging if they don't respond. CT could be crucial later.

Shonda 6 months ago

↳ replying to Kathrine

True, but fluids are usually the first step in hypovolemic shock.

Raul 7 months ago

↳ replying to Kathrine

But what if they need vasopressors instead? That could help too.

Lelia 7 months ago

↳ replying to Kathrine

I agree, a second fluid challenge makes sense. We need to stabilize them.

Ines 12 months ago

I remember that imaging like a CT scan isn't usually the first step in managing shock, but I can't remember the exact order of interventions.

Trina 12 months ago

I feel like we should definitely do something about that high heart rate, but I can't recall if it's better to give more fluids or start a vasopressor first.

Catherin 12 months ago

I think I saw a similar question in our practice exams where vasopressors were indicated for low BP after fluids.

Tegan 1 year ago

I remember we discussed fluid resuscitation in trauma cases, but I'm not sure if a second fluid challenge is the best option here.

AACN CCRN-Adult Exam - Topic 2 Question 15 Discussion