The nurse admits a patient with a low BP who reports severe diarrhea for several days from a Clostridium difficile infection. Which IV fluid would the nurse associate with the need to rapidly replace the patient's fluid volume?
0.45% sodium chloride
0.9% sodium chloride
5% dextrose in 0.9% sodium chloride
5% dextrose in 0.45% sodium chloride
The Correct Answer is B
Choice A reason: 0.45% sodium chloride is a hypotonic solution, which is not ideal for rapidly replacing fluid volume in patients with low blood pressure due to severe diarrhea. Hypotonic solutions can cause fluid to move into cells rather than staying in the vascular space, potentially worsening hypotension.
Choice B reason: 0.9% sodium chloride, also known as normal saline, is an isotonic solution. It is the best choice for rapidly replacing fluid volume in patients with low blood pressure. Isotonic solutions stay in the vascular space and help restore circulating blood volume and blood pressure without causing fluid shifts that can lead to cellular edema or dehydration.
Choice C reason: 5% dextrose in 0.9% sodium chloride is a hypertonic solution, which might not be the most appropriate for initial rapid fluid resuscitation. Hypertonic solutions can draw fluid into the vascular space from the interstitial and intracellular spaces, potentially leading to rapid changes in fluid balance and electrolyte shifts.
Choice D reason: 5% dextrose in 0.45% sodium chloride is also a hypertonic solution but with a hypotonic component (0.45% sodium chloride). This combination is not typically used for rapid fluid resuscitation because it can cause fluid shifts that are less predictable and may complicate the patient's electrolyte balance and hydration status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B"]
Explanation
Choice A reason: Warfarin should be held before surgery due to its anticoagulant properties. Continuing warfarin increases the risk of excessive bleeding during and after surgery. The patient's INR level is already elevated, indicating a higher risk of bleeding.
Choice B reason: Metformin should be held before surgery, especially for patients undergoing procedures that involve the use of contrast dye or anesthesia. Metformin can cause lactic acidosis in patients with renal impairment or when kidney function is affected by contrast agents or surgery.
Choice C reason: Lisinopril is an ACE inhibitor used to manage blood pressure. While some guidelines suggest holding ACE inhibitors before surgery due to the risk of intraoperative hypotension, this decision is often individualized based on the patient's condition and the type of surgery. It is not as universally indicated to be held as warfarin and metformin.
Correct Answer is D
Explanation
Choice A reason: Liver cirrhosis is characterized by chronic liver damage leading to scarring and liver failure. The typical lab findings for liver cirrhosis would include elevated liver enzymes (ALT, AST), bilirubin, and low albumin levels, which are not mentioned in the given test results.
Choice B reason: Acute hepatitis refers to the inflammation of the liver, usually caused by viral infections or toxins. Lab results consistent with acute hepatitis would show elevated liver enzymes (ALT, AST) significantly higher than normal, which are not provided in the text.
Choice C reason: Cholecystitis is the inflammation of the gallbladder, often due to gallstones. Lab findings for cholecystitis may include elevated white blood cell count and sometimes mild elevation of liver enzymes, but not the specific elevated levels of serum amylase and lipase.
Choice D reason: Acute pancreatitis is an inflammation of the pancreas, and the hallmark lab findings include significantly elevated serum amylase and lipase levels. The test results show serum amylase of 920 units/L (reference: 30-220 units/L) and serum lipase of 704 units/L (reference: 0-160 units/L), which are highly indicative of acute pancreatitis. Elevated serum glucose and low serum calcium levels are also consistent with this diagnosis.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
