A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment data represents an adverse outcome (side effect) of this infusion?
There are crackles throughout both lung fields.
The patient's radial pulse is 105 beats/min.
There is sediment and blood in the patient's urine
The blood pressure increases from 66/50 to 122/74 mm
The Correct Answer is A
A 3% saline solution is a hypertonic solution used to increase serum sodium levels in cases of severe hyponatremia. However, it can lead to fluid overload and pulmonary edema. The presence of crackles throughout both lung fields indicates the accumulation of fluid in the lungs, which is a serious adverse outcome.
The patient's radial pulse rate of 105 beats/min is within a normal range and does not directly indicate an adverse effect of the saline infusion.
The presence of sediment and blood in the patient's urine may be unrelated to the 3% saline infusion and could indicate other issues such as urinary tract infection or kidney injury.
An increase in blood pressure from 66/50 to 122/74 mmHg is an expected effect of a hypertonic solution like 3% saline, as it can cause an increase in intravascular volume. While the increase in blood pressure is significant, it does not represent an adverse outcome specific to the infusion itself.
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Correct Answer is B
Explanation
Pernicious anemia is a type of anemia that occurs due to a lack of intrinsic factor, a protein necessary for the absorption of vitamin B12 (cobalamin) in the digestive system. As a result, patients with pernicious anemia are unable to absorb sufficient amounts of vitamin B12 from dietary sources. The treatment for pernicious anemia involves regular administration of cobalamin (B12) injections to bypass the impaired absorption and provide the necessary vitamin B12 directly.
Oral ferrous sulfate tablets are not the appropriate treatment for pernicious anemia. Ferrous sulfate is a form of iron supplement used to treat iron deficiency anemia, which is different from pernicious anemia.
Iron dextran infusions are also not indicated for pernicious anemia. Iron dextran is used for iron replacement therapy in cases of iron deficiency anemia, but it does not address the underlying issue of vitamin B12 deficiency in pernicious anemia.
Routine blood transfusions may be necessary in some cases of pernicious anemia, especially if the patient is severely anemic. However, the primary treatment for pernicious anemia is cobalamin (B12) injections, which provide the necessary vitamin B12 that the patient is unable to absorb.
Correct Answer is B
Explanation
Venous thromboembolism refers to the formation of blood clots in the veins, which can lead to serious complications such as pulmonary embolism. After surgery, immobility and reduced activity can increase the risk of developing blood clots. Therefore, it is crucial to prioritize measures to prevent venous thromboembolism, such as early mobilization, compression stockings, and anticoagulant medications, to ensure the patient's safety and well-being.
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