A client is admitted to the hospital with hypoalbuminemia and shock.
The nurse is preparing to start an intravenous (IV) infusion.
Which of the following IV fluids is the most appropriate for this client?
Albumin (5% or 25%).
Dextrans (Dextran-40 or Dextran-70).
Gelatin (Gelofusine or Haemaccel).
Plasma protein fraction (Plasmanate or Plasmasteril).
The Correct Answer is A
Choice A rationale:
Albumin (5% or 25%) Albumin is the most appropriate IV fluid for a client with hypoalbuminemia and shock.
Albumin is a colloid solution that helps to increase oncotic pressure, which can be decreased in conditions like hypoalbuminemia.
This increased oncotic pressure can help draw fluids back into the vascular space, improving intravascular volume and blood pressure.
Therefore, it is a suitable choice for a patient with shock.
The two concentrations mentioned, 5% and 25%, refer to the percentage of albumin in the solution, and the choice between them depends on the severity of the patient's condition and the desired effect.
The 5% solution is often used for volume expansion and to improve hemodynamics, while the 25% solution is used for rapid volume expansion.
Choice B rationale:
Dextrans (Dextran-40 or Dextran-70) Dextrans are another type of colloid solution, but they are not the best choice for this specific situation.
Dextrans are often used as volume expanders but are more commonly employed in conditions where there is no issue with albumin levels.
In this case, the primary concern is hypoalbuminemia, and using albumin-based solutions would be more appropriate.
Choice C rationale:
Gelatin (Gelofusine or Haemaccel) Gelatin-based solutions are also colloids and can be used for volume expansion.
However, they are not the best choice for a patient with hypoalbuminemia because they do not address the low albumin levels.
Albumin solutions are preferred in such cases to help restore oncotic pressure and improve intravascular volume.
Choice D rationale:
Plasma protein fraction (Plasmanate or Plasmasteril) Plasma protein fraction solutions, also known as human albumin, are similar to albumin solutions.
However, in this context, albumin solutions are more commonly used.
Plasma protein fraction solutions may be indicated in specific situations, but the primary choice for a patient with hypoalbuminemia and shock would be albumin-based solutions, as they are specifically designed to address albumin deficiencies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Vital signs are essential in assessing dehydration.
An elevated heart rate may indicate compensatory mechanisms due to decreased intravascular volume.
Low blood pressure may suggest severe dehydration, and abnormal temperature may indicate an underlying infection.
These parameters provide crucial information about the child's circulatory status, helping to assess the severity of dehydration.
Choice B rationale:
Physical examination findings, such as skin turgor and mucous membrane moisture, are valuable indicators of dehydration.
Poor skin turgor, where the skin doesn't return to its normal position promptly when pinched, indicates decreased tissue turgor due to fluid loss.
Dry mucous membranes, including the mouth, suggest dehydration and help evaluate the extent of fluid deficit.
These signs offer direct visual clues about the child's hydration status.
Choice C rationale:
Laboratory tests play a significant role in diagnosing dehydration.
A complete blood count (CBC) helps identify elevated hematocrit levels, indicating hemoconcentration due to fluid loss.
Electrolyte levels, specifically sodium and potassium, provide insights into the child's electrolyte balance, which can be disrupted in dehydration.
Urine specific gravity measures the kidney's ability to concentrate urine; a high specific gravity suggests concentrated urine due to reduced fluid intake.
These tests aid in confirming the diagnosis and assessing the severity of dehydration.
Choice D rationale:
Assessing the child's history is fundamental in understanding the underlying cause of dehydration.
Recent fluid intake and urine output patterns help determine the balance between intake and output.
Symptoms such as diarrhea, vomiting, and fever indicate potential causes of fluid loss.
Additionally, evaluating the child's overall health and any recent illnesses provides context for the dehydration, guiding appropriate treatment.
Correct Answer is A
Explanation
Choice A rationale:
“This fluid will help to increase your sodium levels which are currently too low.”.
The nurse should explain to the client that they are receiving Normal Saline (0.9% NaCl) to increase their sodium levels.
This is The correct choice because Normal Saline is a hypertonic solution containing 154 mEq/L of sodium and 154 mEq/L of chloride.
It is used in cases of hyponatremia to raise sodium levels.
Sodium is an essential electrolyte, and low levels can lead to symptoms such as weakness, confusion, and muscle cramps.
Choice B rationale:
“This fluid will help to decrease your sodium levels which are currently too high.”.
Normal Saline is a hypertonic solution that would not be used to lower sodium levels, as it would have the opposite effect and further elevate sodium levels.
Choice C rationale:
“This fluid will help to increase your potassium levels which are currently too low.”.
It is not used to increase potassium levels, and potassium replacement would require a different solution, such as potassium chloride.
Choice D rationale:
“This fluid will help to decrease your potassium levels which are currently too high.”.
Normal Saline does not address high potassium levels; it is used to address hyponatremia and dehydration by increasing sodium levels.
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