A nurse is assisting in the plan of care for a client who has hypernatremia. Which of the following IV solutions should the nurse plan to initiate?

25% albumin

Dextrose 10% in water

Dextrose 5% in water

Dextran 40

Answer and Explanation

The Correct Answer is C

C. Dextrose 5% in water is a hypotonic solution that contains 5 grams of dextrose in each 100 mL of water. It provides free water without adding significant sodium, which helps to dilute the elevated sodium levels in hypernatremia. This solution is effective in correcting hypernatremia by promoting water movement from the intravascular space into the cells and extracellular space.

A. Albumin solutions are primarily used for volume expansion and to increase oncotic pressure in conditions like hypoalbuminemia or shock. They do not provide free water and are not typically used for treating hypernatremia.

B. Dextrose 10% in water is a hypertonic solution used primarily for providing calories and treating hypoglycemia. It does not correct hypernatremia because it does not significantly affect sodium levels or provide sufficient free water to dilute sodium.

D. Dextran 40 is a colloid solution that is used for volume expansion in hypovolemia or shock. It does not provide free water and is not indicated for correcting hypernatremia.

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Correct Answer is B

Explanation

B When drawing medication from an ampule, especially if it's a solution that may contain particulate matter or to ensure sterility, using a filter needle is recommended. A filter needle has a membrane filter that prevents particles from being drawn into the syringe while allowing the medication to pass through.

A. Shaking a glass ampule is not recommended because it can lead to the introduction of glass particles or cause the solution to foam or become contaminated. Instead, gently flicking the ampule with a finger can help move any solution that may be adhering to the neck downward, but shaking should be avoided.

C. While wearing gloves is important for infection control, sterile gloves are not typically required for withdrawing medication from a single-dose glass ampule. Standard aseptic technique and hand hygiene are usually sufficient.

D. Ampules are designed to be opened by snapping the top away from the body to avoid potential injury from glass shards. The nurse should use a gauze pad or an ampule opener to break the ampule open safely, directing any breakage away from themselves and others.

A. Intake 2,400 mL, output 2.500 mL B. Intake 1,200 mL, output 700 mL C. Intake 800 mL output 2,100 mL D. Intake 2.500 mL output 500 mL

Correct Answer is A

Explanation

A. This indicates a slight positive fluid balance (+100 mL), meaning the client has taken in slightly more fluids than they have excreted. This could be acceptable depending on the client's clinical condition and fluid status.

B. This indicates a negative fluid balance (-500 mL), suggesting the client has excreted more fluids than they have taken in. In some situations, such as in patients with certain conditions like edema, a negative balance might be intended.

C. This indicates a significant negative fluid balance (-1,300 mL), where the client has excreted much more fluid than they have taken in. This could indicate dehydration or fluid loss that needs to be addressed promptly.

D. This indicates a significant positive fluid balance (+2,000 mL), where the client has taken in much more fluid than they have excreted. This could indicate fluid retention, which might be acceptable in certain clinical conditions but could be problematic in others, such as in patients with congestive heart failure.

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A nurse is assisting in the plan of care for a client who has hypernatremia. Which of the following IV solutions should the nurse plan to initiate?

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