A client with dry skin and mucous membranes is weak, has orthostatic blood pressure changes, and has decreased urine output. The serum osmolality is 290 mOsm/kg. What IV fluid should the nurse anticipate being prescribed for this client?

0.45% Sodium Chloride

10% dextrose in water

5% dextrose in water

0.9% Sodium Chloride

Answer and Explanation

The Correct Answer is D

A. 0.45% Sodium Chloride: This is a hypotonic solution, which is not appropriate for a client with normal serum osmolality (290 mOsm/kg). It may cause fluid shifts that are not desirable in this context.
B. 10% dextrose in water: This hypertonic solution is generally used for providing calories rather than correcting fluid imbalance and is not suitable for initial rehydration in this scenario.
C. 5% dextrose in water: This solution is isotonic in the bag but becomes hypotonic in the body. It is not the best choice for rehydrating a client with normal serum osmolality and significant fluid loss.
D. 0.9% Sodium Chloride: This isotonic solution is appropriate for rehydration in a client with normal serum osmolality. It helps restore extracellular fluid volume without causing fluid shifts, making it ideal for this situation.

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Correct Answer is C

Explanation

A. Abdomen soft, surgical dressing has scant amount of old drainage: A soft abdomen and minimal old drainage from the surgical dressing are expected findings postoperatively. They do not indicate an immediate concern that requires prompt action.
B. Client ambulating with minimal assistance, complaints of occasional nausea: Ambulation and occasional nausea are common and generally expected postoperatively. These findings do not require urgent collaboration with the healthcare provider.
C. Crackles bilaterally in bases of lungs, has incisional pain: Crackles in the lungs can indicate fluid accumulation or atelectasis, which may lead to pneumonia or other respiratory complications. This finding, especially combined with recent surgery, requires prompt evaluation and intervention.
D. Temperature 99.4°F (37.4°C), pulse 100 bpm, bowel sounds present: A slightly elevated temperature and increased pulse are common after surgery. The presence of bowel sounds is a positive sign indicating the return of gastrointestinal function. These findings are not immediately concerning.

A. Weakness in upper extremities B. Headache C. Increased respiratory rate D. Blurred vision

Correct Answer is B

Explanation

A. Weakness in upper extremities: Spinal anesthesia generally affects the lower body, so weakness in the upper extremities is not typically related to this type of anesthesia.
B. Headache: This is the correct choice. A headache is a common post-operative complaint related to spinal anesthesia, often caused by a spinal fluid leak, leading to a post-dural puncture headache.
C. Increased respiratory rate: Spinal anesthesia typically does not affect respiratory rate significantly; it mainly impacts sensation and motor function below the level of anesthesia.
D. Blurred vision: This is not a common issue directly related to spinal anesthesia. Visual disturbances are not typical post-operative complaints associated with spinal anesthesia.

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A client with dry skin and mucous membranes is weak, has orthostatic blood pressure changes, and has decreased urine output. The serum osmolality is 290 mOsm/kg. What IV fluid should the nurse anticipate being prescribed for this client?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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