For the client mentioned above (nausea/vomiting, Salmonella infection), the nurse anticipates an order for which of the following IV fluids?

Choice A reason: This statement is false. 3% Sodium Chloride is a hypertonic solution that can cause fluid overload, hypernatremia, and cellular dehydration. It is not indicated for a patient with nausea, vomiting, and Salmonella infection, who is likely to have fluid and electrolyte losses.

Choice B reason: This statement is false. Dextrose 10% in water is a hypotonic solution that can cause fluid shifts, hyponatremia, and cellular edema. It is not indicated for a patient with nausea, vomiting, and Salmonella infection, who is likely to have fluid and electrolyte losses.

Choice C reason: This statement is true. 0.9% Sodium Chloride with 40 mEq Potassium (KCl) is an isotonic solution that can maintain fluid and electrolyte balance. It is indicated for a patient with nausea, vomiting, and Salmonella infection, who is likely to have fluid and electrolyte losses, especially sodium and potassium.

Choice D reason: This statement is false. Lactated Ringers is an isotonic solution that can maintain fluid and electrolyte balance, but it also contains lactate, which can be converted to bicarbonate in the liver. It is not indicated for a patient with nausea, vomiting, and Salmonella infection, who may have metabolic acidosis due to diarrhea and lactate accumulation.

Choice A reason: I will always need to take hydrocortisone pills is a correct statement. Hydrocortisone is a synthetic form of cortisol, a hormone that is normally produced by the adrenal glands. After a bilateral adrenalectomy, the patient will have no adrenal glands and will need to take hydrocortisone pills for life to replace the missing hormone.

Choice B reason: I have a way to inject hydrocortisone in case of emergency is also a correct statement. Hydrocortisone injections are used to treat acute adrenal crisis, a life-threatening condition that can occur when the patient has low cortisol levels due to stress, illness, injury, or surgery. The patient should have an emergency kit with hydrocortisone injections and instructions on how to use them.

Choice C reason: I will stop taking hydrocortisone when I feel better is an incorrect statement. This indicates a need for further education regarding medications after a bilateral adrenalectomy. The patient should never stop taking hydrocortisone without consulting their doctor, as this can cause severe symptoms of adrenal insufficiency, such as low blood pressure, low blood sugar, weakness, fatigue, and confusion.

Choice D reason: I have nausea or vomiting often is a statement that requires further assessment by the nurse. Nausea or vomiting can be signs of inadequate or excessive hydrocortisone dosage, or other complications after a bilateral adrenalectomy. The nurse should monitor the patient's vital signs, blood glucose, electrolytes, and weight, and report any abnormal findings to the doctor. The patient may need to adjust their hydrocortisone dose or take other medications to manage their symptoms.