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

Answer and Explanation

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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Correct Answer is A

Explanation

A. A patient who lost 2 liters of blood during surgery: This is the most acute and severe form of hypovolemia due to significant blood loss, requiring immediate fluid replacement and hemodynamic monitoring.

B. A patient who received 6 liters of IV fluid: This patient is at risk for hypervolemia, not hypovolemia, due to fluid overload.

C. A patient with UTI on PO meds: While dehydration may occur, it is typically mild and does not cause hypovolemia.

D. A patient with congestive heart failure: CHF usually leads to fluid retention, making hypovolemia unlikely unless there are other complicating factors.

A. Increased salivation B. Decreased level of consciousness C. Hypertension D. Cool, clammy skin

Correct Answer is B

Explanation

A. Increased salivation: Increased salivation is not typically associated with hypernatremia.

B. Decreased level of consciousness: Hypernatremia can cause cellular dehydration, which can lead to neurological symptoms such as confusion, irritability, and decreased level of consciousness.

C. Hypertension: Although hypernatremia can cause fluid retention and contribute to increased blood pressure, the primary concern is neurological changes due to the effect of sodium on cell function.

D. Cool, clammy skin: Cool, clammy skin is more often seen with hypovolemic shock or other conditions like sepsis or hypothermia, not hypernatremia.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a group of patients. Which patient is at highest risk for hypovolemia?

Correct Answer is A

Explanation

A nurse is collecting data from a client who has a sodium level of 155 mEq/L (136-145 mEq/L). Which of the following manifestations should the nurse expect?

Correct Answer is B

Explanation

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