A client presents to the emergency department complaining of several days of nausea and vomiting with weakness and dizziness. The client's vital signs are: Pulse 110, BP 88/56, RR 24, SpO2 95% on room air, temperature of 100.2. The client's lung sounds are clear bilaterally. Which of the following IV fluids would the nurse expect to administer?
Dextrose in water
6.45% Sodium Chloride
10% Dextrose in water
0.9% Sodium Chloride
The Correct Answer is D
A. Dextrose in water is typically used for hydration and to provide some calories. However, this client is presenting with hypotension (BP 88/56), tachycardia (Pulse 110), and weakness, likely due to fluid loss from vomiting. This client needs fluid resuscitation with a solution that will help restore circulating volume, and Dextrose in water does not contain sodium, which is necessary for fluid balance in this case.
B. 6.45% Sodium Chloride is a hypertonic saline solution, which would increase the osmolarity of the blood and pull fluid into the bloodstream. This would not be the first choice for this patient, as it could exacerbate dehydration and electrolyte imbalances.
C. 10% Dextrose in water is also a hypertonic solution that would provide energy but would not adequately address the client's fluid volume deficit or hypotension.
D. 0.9% Sodium Chloride is normal saline, which is an isotonic solution and is the most appropriate choice for fluid resuscitation in this client. It will help restore circulating blood volume, stabilize blood pressure, and provide the necessary hydration to address the client's symptoms of dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Hypertonic fluids are not contraindicated in patients with cerebral edema. In fact, they are often used to reduce cerebral swelling by drawing fluid out of the brain tissue into the bloodstream.
B. Hypertonic saline (3%) is used to shift fluid out of brain tissue in conditions such as cerebral edema. It creates an osmotic gradient, pulling water from the intracellular space into the extracellular and vascular compartments, reducing intracranial pressure.
C. Hypertonic saline is not used for clients with hypernatremia because it would exacerbate the condition by further increasing sodium levels.
D. Hypertonic fluids do not promote hydration of brain tissue. Instead, they work to reduce excess fluid in the brain by creating an osmotic effect.
Correct Answer is C
Explanation
A. Decreasing fluid intake can actually increase the risk of urinary tract infections (UTIs) because it leads to concentrated urine and less frequent urination, which reduces the ability to flush bacteria from the urinary tract.
B. Cleansing the perineal area from back to front increases the risk of transferring bacteria from the rectum to the urethra, which is a common cause of UTIs. The correct technique is to cleanse from front to back.
C. Utilizing cotton rather than synthetic undergarments is beneficial because cotton is breathable and helps keep the genital area dry, reducing the risk of bacterial growth and infection.
D. Urinary tract infections are unavoidable in the elderly is not true. While the elderly may be at increased risk due to factors such as weakened immune systems, UTIs can often be prevented with proper hygiene, hydration, and lifestyle changes.
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