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 D
Explanation
Choice A reason: The nurse assistant typically performs tasks such as patient hygiene, ambulation, and basic monitoring under the supervision of registered nurses. They are not usually responsible for documenting vital signs during the intra-operative period.
Choice B reason: The anesthesiologist is primarily focused on managing the patient's anesthesia and monitoring their physiological status during surgery. While they do keep track of vital signs, the formal documentation is typically the responsibility of the circulating nurse.
Choice C reason: The scrub nurse is focused on maintaining the sterile field, handling surgical instruments, and assisting the surgeon. They do not leave the sterile field to document vital signs.
Choice D reason: The circulating nurse is responsible for overall patient care in the operating room, including documentation of vital signs. They manage the operating room environment, ensure patient safety, and record all necessary information during the intra-operative period.
Correct Answer is A
Explanation
Choice A reason: Hypertension, often called the "silent killer," is usually asymptomatic until significant target organ damage has occurred. This means that many people with hypertension do not experience symptoms until their blood pressure has been high for a long time, leading to damage in organs such as the heart, kidneys, brain, and eyes. Therefore, it's crucial for patients to understand the importance of regular blood pressure monitoring and management even in the absence of symptoms.
Choice B reason: While annual BP checks are useful for monitoring treatment effectiveness, more frequent monitoring may be necessary for newly diagnosed patients or those with poorly controlled hypertension. This information is important but not the most critical point compared to understanding the asymptomatic nature of hypertension.
Choice C reason: Increasing physical activity can help control blood pressure for many individuals, but it is not universally effective for everyone. While important, this information is part of a broader lifestyle modification plan rather than the single most critical point to emphasize.
Choice D reason: Dietary changes can play a significant role in controlling blood pressure, but not all individuals can control their BP through diet alone. Emphasizing this may give a false sense of control without highlighting the importance of medication and other interventions when needed.
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