Exhibits

The practical nurse (PN) suspects elder mistreatment.

Click to indicate if the listed manifestation of abuse is consistent with physical abuse, abandonment, or neglect. Each row must have only one response option selected.

A. Oxygen Concentration of the Ambient Air
The oxygen concentration of the ambient air affects how much oxygen the child could have been exposed to once retrieved from the pool. If the child was submerged in water, the ability to access oxygen from the environment was compromised, which contributes to the level of hypoxemia experienced. Ambient air oxygen concentration is a crucial factor in determining how long it might take for hypoxemia to develop or improve after submersion.
B. Temperature of Water
The temperature of the water affects the child’s physiology during submersion. Cold water can lead to a more rapid decrease in core body temperature and can influence the child’s respiratory and cardiovascular responses, potentially affecting the degree of hypoxemia.
C. The Weight of the Child
The weight of the child does not significantly impact the level of hypoxemia experienced during submersion. While it might influence the child’s ability to stay afloat or the rescue process, it does not directly affect hypoxemia levels.
D. The Amount of Time the Child Was Submerged
The duration of submersion is a critical factor in determining the level of hypoxemia. Longer submersion times result in more significant oxygen deprivation and a greater degree of hypoxemia, which can impact the severity of respiratory and cardiac complications.
E. Whether or Not Anyone Witnessed the Fall into the Pool
While witnessing the fall might be relevant for understanding the context of the incident, it does not directly affect the level of hypoxemia experienced during the submersion. The key factors are related to the conditions and duration of the submersion itself

A. 50% dextrose
50% dextrose is not isotonic; it is a hypertonic solution. Hypertonic solutions have a higher concentration of solutes compared to the cells, causing water to move out of the cells and into the extracellular space, which does not treat fluid volume deficit effectively.
B. 0.45% sodium chloride
0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution. Hypotonic solutions have a lower concentration of solutes compared to the cells, which would cause water to move into the cells rather than stay in the extracellular space to address fluid volume deficit.
C. 20% dextrose
20% dextrose is a hypertonic solution. It contains a higher concentration of dextrose compared to the extracellular fluid, which draws water into the extracellular space but is not used for treating fluid volume deficits.
D. 5% dextrose
5% dextrose (D5W) is initially isotonic but becomes hypotonic once metabolized, as the dextrose is used up and only water remains. It is not suitable for continuous isotonic fluid therapy for fluid volume deficit.
E. 5% dextrose with 0.45% sodium chloride
5% dextrose with 0.45% sodium chloride is a hypertonic solution. While it starts isotonic, it becomes hypotonic once the dextrose is metabolized, making it unsuitable for long-term isotonic fluid replacement.
F. 5% dextrose with lactated Ringer's
5% dextrose with lactated Ringer's is a hypertonic solution. It contains both dextrose and electrolytes, which are not purely isotonic and may not be ideal for addressing fluid volume deficits on their own.
G. Lactated Ringer's
Lactated Ringer's is an isotonic solution. It has a similar osmolarity to plasma and is used for fluid volume replacement, helping to restore blood volume and maintain electrolyte balance.
H. 0.9% sodium chloride
0.9% sodium chloride, or normal saline, is an isotonic solution. It has the same osmolarity as plasma and is commonly used for fluid volume replacement and maintaining hydration