A nurse is discussing safety for administering intravenous fluids. Which condition might occur if hypertonic solutions are administered too quickly?

Choice A reason: This is not a correct answer because 0.9% Sodium Chloride is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice B reason: This is not a correct answer because Lactated Ringer's is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice C reason: This is not a correct answer because D5W (5% Dextrose in Water) is an isotonic solution when it is in the IV bag, but it becomes hypotonic once it enters the body, as the dextrose is rapidly metabolized and only water remains. However, it is not a preferred solution for a patient with critically high sodium, as it can cause cerebral edema and worsen the neurological status.

Choice D reason: This is a correct answer because 0.45% Sodium Chloride is a hypotonic solution, which means it has a lower osmolarity than the blood plasma. It causes fluid to shift from the extracellular to the intracellular compartment, which can help lower the sodium level and correct the fluid imbalance.

Choice A reason: Slowing the rate to 50 mL/hr is not an appropriate action by the nurse before calling the physician to clarify the order. This could cause the client to become more hypovolemic, which is a condition where there is a decreased volume of blood in the body. Hypovolemia can lead to shock, organ failure, and death.

Choice B reason: Slowing the rate to 20 mL/hr is not an appropriate action by the nurse before calling the physician to clarify the order. This could also cause the client to become more hypovolemic, which is a serious and life-threatening condition. The nurse should not reduce the IV fluid rate without a physician's order.

Choice C reason: Increasing the rate to 250 mL/hr is not an appropriate action by the nurse before calling the physician to clarify the order. This could cause the client to become more hypervolemic, which is a condition where there is an excess of fluid in the blood vessels. Hypervolemia can cause fluid overload, pulmonary edema, and heart failure.

Choice D reason: Continuing the rate at 125 mL/hr is an appropriate action by the nurse before calling the physician to clarify the order. This is a reasonable rate for a client who has a head injury and hypovolemia, as it can help restore the fluid balance and prevent cerebral edema. The nurse should not change the IV fluid rate without a physician's order.