The health care provider has ordered a hypotonic intravenous (IV) solution to be administered. Which IV bag will the nurse prepare?

0.9% sodium chloride (NS)

0.45% sodium chloride (1/2 NS)

Dextrose 5% in Lactated Ringer's (DSLR)

Lactated Ringer's (LR)

Answer and Explanation

The Correct Answer is B

A.   0.9% sodium chloride, also known as Normal Saline, is an isotonic solution. It has the same concentration of solutes as blood plasma, which means it does not change the cell's fluid volume but rather maintains it. It is not considered hypotonic.

B.   0.45% sodium chloride, commonly known as Half Normal Saline, is a hypotonic solution. It has a lower concentration of sodium chloride compared to the normal saline and is used to provide hydration and to help correct electrolyte imbalances by allowing water to move into the cells.
C.   Dextrose 5% in Lactated Ringer's is not a hypotonic solution. It is actually a type of hypertonic solution. Initially, dextrose 5% is isotonic, but once the dextrose is metabolized, the solution becomes hypotonic due to the electrolyte content of Lactated Ringer’s. However, the classification is generally based on the solution before metabolism, and it is not commonly used as a hypotonic solution.
D.   Lactated Ringer's solution is an isotonic solution. It contains electrolytes in concentrations similar to those found in the body's plasma, and it is used to restore fluids and electrolytes. It does not have a hypotonic effect on cells.

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Correct Answer is A

Explanation

A. pH: Elevated (above 7.45), indicating alkalosis. PaCO₂: Decreased (below 35 mm Hg), reflecting hyperventilation and CO₂ loss. HCO₃⁻: Usually normal (around 24 mEq/L) or slightly decreased, as metabolic compensation might not be immediate. The results here show an elevated pH, decreased PaCO₂, and normal HCO₃⁻, which are consistent with respiratory alkalosis.
B. pH: Decreased (acidic), indicating acidosis. PaCO₂: Slightly elevated (near normal), not indicative of respiratory alkalosis. HCO₃⁻: Normal (around 26 mEq/L), suggesting no significant metabolic component or compensation. This profile does not match respiratory alkalosis; it is more consistent with a mixed or different type of acid-base imbalance.
C. pH: Decreased (acidic), indicating acidosis. PaCO₂: Elevated (above 45 mm Hg), indicating CO₂ retention, which is characteristic of respiratory acidosis, not alkalosis. HCO₃⁻: Normal (around 23 mEq/L), showing no significant metabolic compensation or disturbance. This profile indicates respiratory acidosis rather than respiratory alkalosis.
D. pH: Elevated (alkaline), which is consistent with alkalosis. PaCO₂: Normal (around 40 mm Hg), indicating that CO₂ levels are not the primary cause of the alkalosis. HCO₃⁻: Elevated (above 28 mEq/L), suggesting a metabolic alkalosis or compensation for a respiratory acidosis, but not respiratory alkalosis alone.

A. Use a nonrebreather mask to deliver low-flow oxygen B. A nonrebreather mask should fit snugly over a client's face. C. The reservoir bag on a nonrebreather mask should collapse with D. A nonrebreather mask dries a client's mucous membranes

Correct Answer is B

Explanation

A. A nonrebreather mask is used to deliver high-flow oxygen, not low-flow. It provides the highest concentration of oxygen compared to other types of masks, which is crucial for patients with severe hypoxemia. The high-flow oxygen helps in achieving a higher concentration of oxygen in the blood.
B. It is essential that a nonrebreather mask fits snugly over the client's face to ensure that the patient receives the maximum amount of oxygen and to prevent room air from mixing with the oxygen being delivered. A proper seal is necessary to achieve the desired level of oxygenation and to avoid oxygen leakage.
C. The reservoir bag on a nonrebreather mask should not collapse with each breath. Ideally, the bag should remain partially inflated even during inspiration. If the bag collapses completely, it indicates that the patient is not receiving enough oxygen, and the mask may not be functioning correctly.
D. A nonrebreather mask itself does not cause drying of the mucous membranes. However, high-flow oxygen can sometimes lead to dryness of the mucous membranes if not managed properly. Humidification may be required to prevent dryness, but this is not a direct effect of the mask itself.

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The health care provider has ordered a hypotonic intravenous (IV) solution to be administered. Which IV bag will the nurse prepare?

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