A client is about to receive D10W (10% dextrose in water) as part of their treatment plan.
The nurse explains that this intravenous fluid contains Dextrose 100 g/L and Water 900 mL.
Which of the following statements made by the client indicates a correct understanding of their treatment?

Choice A rationale:

Normal saline (0.9% NaCl).

Rationale: Normal saline is the most appropriate choice for a client with dehydration and hyponatremia.

It provides a balanced solution with sodium and chloride, which can help correct hyponatremia and rehydrate the client.

It is an isotonic solution and is commonly used for fluid resuscitation.

Choice B rationale:

Half normal saline (0.45% NaCl).

Rationale: Half normal saline is also an isotonic solution, but it contains less sodium than normal saline.

In a case of hyponatremia, it's better to use a solution with a higher sodium concentration, making choice A (normal saline) more appropriate.

Choice C rationale:

Lactated Ringer’s.

Rationale: Lactated Ringer's is another isotonic solution, but it may not be the best choice for a client with hyponatremia.

It contains lactate, which can be metabolized to bicarbonate, potentially worsening the client's hyponatremia.

Therefore, it's not the most appropriate option in this case.

Choice D rationale:

D5W (5% dextrose in water).

Rationale: D5W is a hypotonic solution and should not be used for rehydration in a client with hyponatremia.

It can exacerbate the electrolyte imbalance and is not suitable for addressing dehydration.

The correct answer is B. Shakiness.

Choice A: Increased capillary refill Capillary refill time (CRT) is a simple and quick test requiring minimal equipment or time to perform. Prolonged CRT is a ‘red flag’ feature, identifying children with increased risk of significant morbidity or mortality. A normal CRT should be between 2-3 seconds when applied centrally, such as to the sternum or the forehead. Therefore, increased capillary refill is not typically associated with hypoglycemia.

Choice B: Shakiness Shakiness, or tremors, are rhythmic shaking movements that most often happen in the hands, but can also occur in the arms, legs, head, vocal cords, and torso. Tremors can occur while a child is resting or active. Shakiness is a common symptom of hypoglycemia.

Choice C: Thirst While it’s true that excessive thirst can be a sign of diabetes, it’s a tricky one when the patient is a child. Young children often drink plenty of fluids when they are perfectly healthy. However, thirst is typically associated with hyperglycemia, not hypoglycemia.

Choice D: Decreased appetite Loss of appetite (anorexia) is a common symptom in children. Acute illness in childhood is often associated with transient loss of appetite. However, decreased appetite is not typically a direct symptom of hypoglycemia.