A client with Cushing's disease is being admitted to the hospital after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem?

A client with Cushing's disease is being admitted to the hospital after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem?

• A. Insomnia
• B. Lack of appetite
• C. Signs of dehydration
• D. Infection

Answer: (C)

The most important thing to monitor first is volume status and signs of dehydration. In a patient who has sustained a stab wound to the abdomen, ongoing blood loss can rapidly lead to hypovolemia and shock if not detected early. Dehydration indicators—such as tachycardia, hypotension, cool/clammy skin, dry mucous membranes, and reduced urine output—signal that circulating blood volume is dropping and urgent fluid resuscitation or transfusion may be needed. Although Cushing’s disease (excess cortisol) does increase susceptibility to infection and can impair inflammatory responses, the immediate life-threatening risk after trauma is loss of circulating volume. That’s why dehydration becomes the highest priority in planning care—the goal is to maintain perfusion and prevent progression to shock. Insomnia, appetite changes, and infection risk are important considerations, but they do not demand as rapid a response as addressing potential dehydration and hypovolemia in the acute setting.

The most important thing to monitor first is volume status and signs of dehydration. In a patient who has sustained a stab wound to the abdomen, ongoing blood loss can rapidly lead to hypovolemia and shock if not detected early. Dehydration indicators—such as tachycardia, hypotension, cool/clammy skin, dry mucous membranes, and reduced urine output—signal that circulating blood volume is dropping and urgent fluid resuscitation or transfusion may be needed.

Although Cushing’s disease (excess cortisol) does increase susceptibility to infection and can impair inflammatory responses, the immediate life-threatening risk after trauma is loss of circulating volume. That’s why dehydration becomes the highest priority in planning care—the goal is to maintain perfusion and prevent progression to shock. Insomnia, appetite changes, and infection risk are important considerations, but they do not demand as rapid a response as addressing potential dehydration and hypovolemia in the acute setting.