A client is admitted to the hospital with burns and hypovolemia.
The nurse is preparing to start an intravenous (IV) infusion.
Which of the following IV fluids is the most appropriate for this client?
Normal saline (0.9% NaCl).
Half normal saline (0.45% NaCl).
Lactated Ringer’s.
D5W (5% dextrose in water).
The Correct Answer is A
Normal saline (0.9% NaCl).
Choice A rationale:
Normal saline (0.9% NaCl) is the most appropriate choice for a client with burns and hypovolemia.
This isotonic solution helps to restore intravascular volume and replace lost fluids.
It contains sodium chloride in a concentration similar to that of the body's extracellular fluid, making it effective for rehydration and replenishing electrolytes in hypovolemic patients.
Choice B rationale:
Half normal saline (0.45% NaCl) is a hypotonic solution with a lower sodium concentration than the body's extracellular fluid.
It is not the best choice for treating hypovolemia and burns because it may not effectively expand intravascular volume and may cause cellular swelling.
Choice C rationale:
Lactated Ringer's is an isotonic solution, but it contains additional electrolytes and lactate.
While it can be suitable for some fluid replacement needs, normal saline is preferred for burn patients because it has a simpler composition and is effective for volume resuscitation in cases of hypovolemia.
Choice D rationale:
D5W (5% dextrose in water) is a solution that primarily provides dextrose for energy, not suitable for hypovolemia and burns.
It can cause dilutional hyponatremia if used as the primary fluid in hypovolemic patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
"The child's favorite foods and beverages" are not relevant when assessing dehydration.
While dietary habits are essential for overall health, they do not provide information about the child's hydration status.
Choice B rationale:
"The child's school attendance and activities" are unrelated to the assessment of dehydration.
School attendance and activities are important for a child's social and educational development but do not provide any insight into the child's fluid balance or hydration status.
Choice C rationale:
"The child's skin turgor and mucous membranes" are crucial indicators of dehydration during physical examination.
Poor skin turgor, where the skin tents or remains elevated after being pinched, suggests decreased tissue elasticity due to fluid loss.
Dry mucous membranes, including the mouth, indicate dehydration.
These signs provide immediate visual clues about the child's hydration status and guide further assessment and intervention.
Choice D rationale:
"The child's vaccination history" is not relevant to the assessment of dehydration.
While vaccination history is essential for preventive healthcare, it does not provide any information about the child's current hydration status or fluid balance.
Correct Answer is C
Explanation
Choice A rationale:
Thirst and dry mouth are common signs of dehydration in adults, but in pediatric patients, especially infants, the signs are different.
Children may not be able to communicate their thirst effectively, and dry mouth might not be as noticeable as other signs.
Choice B rationale:
Rapid heart rate and low blood pressure are symptoms of shock, which can occur in severe dehydration.
However, these symptoms are not specific to dehydration and can be present in other conditions.
Sunken eyes and fontanelle in infants are more specific indicators of dehydration in pediatric patients.
Sunken eyes occur due to loss of tissue turgor, and a sunken fontanelle (the soft spot on an infant's head) is a late sign of dehydration.
Choice D rationale:
Lethargy and irritability can be signs of dehydration, but they are nonspecific and can occur in various pediatric conditions.
Sunken eyes and fontanelle, on the other hand, are more specific to dehydration, especially in infants.
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