The healthcare provider ordered an IV solution for a dehydrated client with a skull fracture. The nurse knows which IV fluid would be contraindicated?
Normal saline
Dextrose in water 5%
Lactated Ringer's (LR)
Dextrose in normal saline
The Correct Answer is B
Choice A reason: Normal saline is not contraindicated for a dehydrated client with a skull fracture. Normal saline is an isotonic solution that has the same concentration of solutes as the blood plasma. It can help restore fluid balance and prevent cerebral edema.
Choice B reason: Dextrose in water 5% is contraindicated for a dehydrated client with a skull fracture. Dextrose in water 5% is a hypotonic solution that has a lower concentration of solutes than the blood plasma. It can cause fluid to shift from the blood vessels into the brain cells, increasing the intracranial pressure and worsening the skull fracture.
Choice C reason: Lactated Ringer's (LR) is not contraindicated for a dehydrated client with a skull fracture. Lactated Ringer's (LR) is an isotonic solution that has the same concentration of solutes as the blood plasma. It can also provide electrolytes such as sodium, potassium, calcium, and lactate, which can help correct acid-base imbalances.
Choice D reason: Dextrose in normal saline is not contraindicated for a dehydrated client with a skull fracture. Dextrose in normal saline is a hypertonic solution that has a higher concentration of solutes than the blood plasma. It can cause fluid to shift from the brain cells into the blood vessels, reducing the intracranial pressure and cerebral edema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not a correct answer because 0.9% Sodium Chloride is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.
Choice B reason: This is not a correct answer because Lactated Ringer's is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.
Choice C reason: This is not a correct answer because D5W (5% Dextrose in Water) is an isotonic solution when it is in the IV bag, but it becomes hypotonic once it enters the body, as the dextrose is rapidly metabolized and only water remains. However, it is not a preferred solution for a patient with critically high sodium, as it can cause cerebral edema and worsen the neurological status.
Choice D reason: This is a correct answer because 0.45% Sodium Chloride is a hypotonic solution, which means it has a lower osmolarity than the blood plasma. It causes fluid to shift from the extracellular to the intracellular compartment, which can help lower the sodium level and correct the fluid imbalance.
Correct Answer is B
Explanation
Choice A reason: This is not a correct answer because intracorporeal lithotripsy is a procedure that uses a laser or an ultrasonic probe to break up gallstones inside the gallbladder or the bile ducts. It is not a preferred treatment for cholecystitis, as it does not remove the inflamed gallbladder.
Choice B reason: This is a correct answer because laparoscopic cholecystectomy is a surgery that removes the gallbladder through small incisions in the abdomen. It is the preferred treatment for cholecystitis, as it eliminates the source of inflammation and prevents further complications.
Choice C reason: This is not a correct answer because extracorporeal shock wave lithotripsy (ESWL) is a procedure that uses shock waves to break up gallstones outside the body. It is not a preferred treatment for cholecystitis, as it does not remove the inflamed gallbladder and may not be effective for all types of gallstones.
Choice D reason: This is not a correct answer because methyl tertiary butyl ether (MTBE) infusion is a procedure that uses a chemical solvent to dissolve gallstones inside the gallbladder. It is not a preferred treatment for cholecystitis, as it does not remove the inflamed gallbladder and may cause side effects such as nausea, vomiting, and liver damage.
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