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

Dextran 40

Dextrose 5 in water

Dextrose 10% in water

25% albumin

Answer and Explanation

The Correct Answer is B

A.   Dextran 40 is a plasma volume expander and not used for correcting hypernatremia.
B.   Hypernatremia indicates a deficit of water relative to sodium. Providing hypotonic solutions like Dextrose 5 in water helps to dilute the sodium concentration in the body fluids, effectively treating hypernatremia.
C.   Dextrose 10% in water is a hypertonic solution and would exacerbate hypernatremia by increasing the concentration of sodium in the body fluids.
D.   25% albumin is a hypertonic solution and would exacerbate hypernatremia by increasing the concentration of sodium in the body fluids.

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Correct Answer is B

Explanation

A. This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B. Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C. This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D. Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.

A. "It is caused by the lack of production of insulin by the pancreas.." B. "It is caused by the overproduction of growth hormone by the pituitary gland." C. "It is caused by the overproduction of parathormone by the parathyroid gland." D. "It is caused by the lack of production of aldosterone by the adrenal gland."

Correct Answer is D

Explanation

A. This statement describes the cause of diabetes mellitus, not Addison's disease.

B. This statement describes the cause of acromegaly, not Addison's disease.

C. This statement describes the cause of hyperparathyroidism, not Addison's disease.

D. This is the correct explanation of the cause of Addison's disease, which involves adrenal insufficiency.

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

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Correct Answer is B

Explanation

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Correct Answer is D

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