A 28-year-old client is admitted to the hospital with severe bleeding from a fractured femur. Which intravenous fluid should the nurse anticipate will be ordered for volume replacement?
10% dextrose in water
10% dextrose in 0.45% sodium chloride
0.9% sodium chloride
2.5% sodium chloride
The Correct Answer is C
A. 10% dextrose in water: This solution is used primarily for providing calories and is not suitable for volume replacement.
B. 10% dextrose in 0.45% sodium chloride: This solution combines dextrose and a hypotonic sodium chloride solution, which is not ideal for immediate volume replacement in severe bleeding cases.
C. 0.9% sodium chloride: This is the correct choice. Normal saline (0.9% sodium chloride) is an isotonic solution used for volume replacement, especially in cases of significant blood loss.
D. 2.5% sodium chloride: This is a hypotonic solution and would not be appropriate for volume replacement in severe bleeding as it does not adequately address the need for fluid resuscitation.
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Related Questions
Correct Answer is D
Explanation
A. Continue monitoring the client: The client's vital signs, pale and cool skin, and low urine output suggest potential hypovolemic shock or other serious postoperative complications, requiring more immediate intervention than just continued monitoring.
B. Increase nasal oxygen flow rate to 8 L: While increasing oxygen may be necessary, the primary concern is the underlying cause of the client's symptoms, which may require more immediate intervention.
C. Place the client in high Fowler's position: This position may be beneficial for certain conditions but does not address the underlying issues suggested by the vital signs and physical findings.
D. Notify the surgeon as soon as possible: This is the correct choice. The client's hypotension, tachycardia, pale and cool skin, and low urine output indicate potential complications that need immediate evaluation by the surgeon.
Correct Answer is D
Explanation
A. Administer 10% sodium chloride via rapid infusion: Rapid infusion of high concentrations of sodium chloride can be dangerous and is not the standard treatment for severe hyponatremia.
B. Administer intranasal antidiuretic hormone: This would not be appropriate for correcting severe hyponatremia and could potentially worsen the condition.
C. Encourage oral fluid intake: For severe hyponatremia, oral fluid intake might not be sufficient and could exacerbate the condition if there is fluid overload.
D. Place the client on seizure precautions: This is the correct choice. Severe hyponatremia (sodium < 120 mEq/L) can lead to neurological symptoms and seizures, so implementing seizure precautions is crucial for safety.
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