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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Holding the skin taut helps stabilize the area and ensures that the needle penetrates the skin smoothly and at the correct angle. This also helps prevent the needle from going too deep or slipping out of the site during injection.
A. The syringe should be held at a 5 to 15-degree angle to the client's skin, not 20 degrees.
B. For a tuberculin skin test (PPD test), typically 0.1 mL (one-tenth of a milliliter) of PPD is injected intradermally. This is a very small amount compared to 0.5 mL.
C. The length of the needle for an intradermal injection is typically shorter than 1 inch, usually around 3/8 to 5/8 inches (10-16 mm). Using a longer needle may increase the risk of inserting the needle too deeply, potentially leading to subcutaneous rather than intradermal injection.
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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