A client is admitted with hypovolemia due to severe bleeding. Which Intravenous fluid does the nurse anticipate using to replace fluid losses?
5% dextrose in 0.25% sodium chloride (D51/4NS)
3% sodium chloride (3% NaCl)
5% dextrose in water (DSW)
0.9% sodium chloride (0.9% NaCl)
The Correct Answer is D
D. 0.9% sodium chloride (0.9% NaCl): This solution, also known as normal saline, is isotonic and contains the same concentration of sodium as extracellular fluid. It is the most appropriate choice for initial fluid resuscitation in hypovolemia due to severe bleeding because it rapidly expands intravascular volume, replaces sodium losses, and helps restore circulating blood volume.
A. This solution contains dextrose (glucose) and a small amount of sodium chloride. It provides some glucose for energy but has a lower sodium concentration compared to isotonic solutions like normal saline. While it may be used in certain situations, such as to provide maintenance fluids or correct mild dehydration, it is not the first choice for fluid resuscitation in hypovolemia due to severe bleeding because it does not adequately replace lost volume.
B. 3% sodium chloride (3% NaCl): This solution is hypertonic and has a high sodium concentration. It is not typically used for initial fluid resuscitation in hypovolemia due to severe bleeding. Hypertonic saline solutions like 3% NaCl are more commonly used in specific situations such as severe hyponatremia or cerebral edema.
C. 5% dextrose in water (D5W): This solution contains only dextrose and water and is isotonic until the dextrose is metabolized, after which it becomes hypotonic. D5W is not suitable for fluid resuscitation in hypovolemia due to severe bleeding because it does not provide adequate sodium or volume replacement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. Full compensation typically occurs within 2 to 3 days (approximately 72 hours) after the onset of an acid-base disturbance. During full compensation, the primary acid-base disorder (e.g., respiratory acidosis or alkalosis, metabolic acidosis or alkalosis) is still present, but the compensatory mechanisms have effectively brought the pH, pCO2, and bicarbonate (pHCO3) levels back towards normal range.
A. Full compensation occurs when both the primary disorder (respiratory or metabolic) and the compensatory mechanism (renal or respiratory) are functioning to return the pH towards normal. In this option, while the pO2 is within the normal range, the pH, pCO2, and bicarbonate (pHCO3) are all abnormal, indicating an ongoing imbalance.
B. Full compensation occurs when all components of the ABG are within or approaching normal range, indicating that the body's compensatory mechanisms have effectively counteracted the primary acid- base disturbance. In this option, the bicarbonate (pHCO3) is mentioned as starting to change, indicating incomplete compensation.
D. While the pH is within the normal range, both the pCO2 and pO2 are abnormal, indicating a primary respiratory disturbance. In the case of full compensation, the pH, pCO2, and bicarbonate (pHCO3) levels would all be within or approaching normal range, indicating that the compensatory mechanisms have effectively counteracted the primary acid-base disturbance.
Correct Answer is B
Explanation
B. A PICC line is a long, flexible catheter inserted into a peripheral vein, typically in the upper arm, and advanced until the tip lies in the superior vena cava or the cavoatrial junction. PICC lines are suitable for long-term venous access and are often used for administering medications, including antibiotics, over several weeks or months. They offer stable and reliable access, reducing the need for frequent venipunctures.
A. Butterfly needles are typically used for short-term venous access, such as for blood draws or administering medications that do not require long-term therapy. They are not suitable for prolonged use or for administering medications over several weeks, as they are not designed for secure and stable access over an extended period.
C. A peripheral IV-lock, also known as a saline lock or heplock, is a short catheter inserted into a peripheral vein and then capped off for intermittent use. While peripheral IV-locks are suitable for short-term venous access, they are not ideal for prolonged therapy lasting several weeks. Additionally, they may not provide the necessary stability and reliability for administering IV antibiotics over an extended period.
D. A small gauge peripheral angiocath refers to a short catheter inserted into a peripheral vein for intravenous access. While a larger gauge catheter, such as a 16-gauge, may allow for faster infusion rates and is suitable for certain situations requiring rapid fluid administration, it may not be the most appropriate choice for long-term IV antibiotic therapy. The choice of gauge depends on factors such as the client's vein size, the viscosity of the medication, and the duration of therapy.
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