A nurse is assisting with the care of a client who is hypovolemic due to blood loss following a motor-vehicle crash and needs a blood transfusion immediately. The nurse should anticipate a prescription for which of the following IV solutions while awaiting blood from a type and cross-match?
Dextrose 10% in water
Lactated Ringer's
0.33% sodium chloride
0.45% sodium chloride
The Correct Answer is B
A. Dextrose 10% in water: Dextrose solutions provide calories but do not restore volume or replace electrolytes. They are not typically used in hypovolemic shock.
B. Lactated Ringer's: Lactated Ringer’s solution is an isotonic solution containing sodium, potassium, calcium, and lactate, which helps restore both fluid volume and electrolytes in the case of hypovolemic shock. It is commonly used while awaiting blood transfusions.
C. 0.33% sodium chloride: This is a hypotonic solution that can cause fluid to shift into cells and is not appropriate for fluid resuscitation in hypovolemia, which requires an isotonic solution.
D. 0.45% sodium chloride: This is a hypotonic solution as well, and it could worsen hypotension by causing fluid shifts into the cells, which is not ideal for treating hypovolemic shock.
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Related Questions
Correct Answer is C
Explanation
A. Skeletal muscle weakness: This is more commonly seen with hypercalcemia, not hypocalcemia. Hypocalcemia typically causes neuromuscular irritability, which manifests as muscle spasms rather than weakness.
B. Decreased deep-tendon reflexes: This is more commonly seen with hypercalcemia. Hypocalcemia typically increases neuromuscular irritability and can cause hyperactive reflexes.
C. Tingling of the lips: This is a classic sign of hypocalcemia, as low calcium levels can lead to neuromuscular excitability, which can cause sensations like tingling (paresthesia) around the lips and fingers.
D. Hypoactive bowel sounds: Hypocalcemia typically increases bowel motility, which can lead to hyperactive bowel sounds, not hypoactive bowel sounds.
Correct Answer is C
Explanation
A. Potassium chloride: Potassium chloride is used to treat hypokalemia, not hyperkalemia.
B. Acetylcysteine: This medication is not used to treat potassium imbalances. It is primarily used to treat acetaminophen overdose or to thin mucus in respiratory conditions.
C. Sodium polystyrene: Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestines, helping to lower serum potassium levels.
D. Potassium iodide: Potassium iodide is used in thyroid conditions (such as thyroid storm) or radiation exposure and is not used to manage potassium levels.
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