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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A rationale:

Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L) The given arterial blood gas (ABG) values indicate a pH of 7.48 (which is alkalotic), a PaCO2 of 38 (within the normal range of 35-45 mm Hg), and an HCO3- of 30 (which is elevated) These values indicate metabolic alkalosis, not metabolic acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L) The given ABG values indicate a pH of 7.48 (which is alkalotic) and an elevated HCO3- of 30, indicating metabolic alkalosis. This condition can result from excessive loss of acids (e.g., vomiting) or excessive intake of bicarbonate or alkali substances.

Choice C rationale:

Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg) The given ABG values indicate a normal pH of 7.48 and a PaCO2 of 38 (within the normal range), ruling out respiratory acidosis.

Choice D rationale:

Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg) The given ABG values indicate a pH of 7.48 (which is alkalotic) and a PaCO2 of 38 (within the normal range), ruling out respiratory alkalosis.

A. The electrolyte is the most abundant intracellular cation present in the body. B. The electrolyte may cause extracellular fluid overload. C. Magnesium may affect neuromuscular excitability and contractility. D. The patient is at risk for hypotension when the levels of magnesium decrease.

Correct Answer is C

Explanation

Choice A rationale:

While magnesium is indeed the most abundant intracellular cation in the body, this fact alone does not explain why the nurse would assess the patient's magnesium level.

Choice B rationale:

Magnesium imbalance can cause issues in the extracellular fluid compartment, but this choice does not explain why the nurse would specifically assess the patient's magnesium level.

Choice D rationale:

While hypotension can be a symptom of severe magnesium deficiency, this choice does not provide a rationale for assessing the patient's magnesium level. In this case, choice C is correct because magnesium plays a crucial role in neuromuscular excitability and contractility. Abnormal magnesium levels can lead to neuromuscular symptoms such as muscle weakness, tremors, and spasms. Additionally, magnesium is involved in cardiac muscle function, and low magnesium levels can lead to arrhythmias and other cardiac issues. Therefore, assessing the patient's magnesium level is essential in understanding their neuromuscular and cardiac health.

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Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?

Correct Answer is B

Explanation

Which rationale supports the nurse's assessment of a patient's magnesium level?

Correct Answer is C

Explanation

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