Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?
0.459% saline.
0.9% NaCl.
5% dextrose in 0.45% saline.
Dextran.
The Correct Answer is B
Choice A rationale:
0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.
Choice B rationale:
0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.
Choice C rationale:
5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.
Choice D rationale:
Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is c. Respiratory acidosis.
Choice A reason: Metabolic acidosis is incorrect because the HCO3 level is normal. In metabolic acidosis, we would expect to see a decreased HCO3.
Choice B reason: Metabolic alkalosis is incorrect because the HCO3 level is normal. In metabolic alkalosis, we would expect to see an increased HCO3.
Choice C reason: The given ABG results indicate a low pH (acidosis), an elevated PaCO2 (respiratory component), and a normal HCO3 (metabolic component). The low pH and increased PaCO2 suggest respiratory acidosis.
Choice D reason: Respiratory alkalosis is incorrect because the PaCO2 level is elevated, not decreased. In respiratory alkalosis, we would expect to see a decreased PaCO2.
Correct Answer is C
Explanation
Choice A rationale:
Serotonin is a neurotransmitter that plays a role in mood regulation, sleep, and other functions in the body. It is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process.
Choice B rationale:
Platelet factor III is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process. Platelet factor III is not widely recognized in the context of clotting; it is more commonly referred to as tissue factor and is involved in the extrinsic pathway of coagulation.
Choice C rationale:
Von Willebrand factor (VWF) is a protein that plays a crucial role in hemostasis. It forms an adhesive bridge between platelets and vascular subendothelial structures, particularly at sites of vascular injury. VWF helps platelets adhere to the injured vessel wall, leading to the formation of a stable blood clot. This process is essential for preventing excessive bleeding. A deficiency or dysfunction in VWF can lead to von Willebrand disease, a bleeding disorder characterized by prolonged bleeding times.
Choice D rationale:
Adenosine diphosphate (ADP) is a molecule released by platelets when they are activated. ADP helps in the aggregation of platelets, but it does not directly form an adhesive bridge between platelets and vascular subendothelial structures.
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