A client is admitted to the hospital with dehydration and hyponatremia.
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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Lethargy and muscle weakness are common signs of electrolyte imbalances in a dehydrated child.
Dehydration can lead to an imbalance of electrolytes, such as sodium and potassium, which affects muscle function and overall energy levels.
Choice B rationale:
Increased appetite and hyperactivity are not typical signs of electrolyte imbalances in a dehydrated child.
Dehydration often leads to a decreased appetite and lethargy.
Choice C rationale:
Shortness of breath and coughing are not directly related to electrolyte imbalances in a dehydrated child.
These symptoms are more likely to be associated with respiratory or pulmonary issues rather than dehydration.
Choice D rationale:
Excessive thirst and urination are common signs of dehydration but are not indicative of electrolyte imbalances.
These symptoms occur as the body attempts to compensate for fluid loss by increasing thirst and increasing urine output.
Electrolyte imbalances are more likely to manifest as muscle weakness and cardiac arrhythmias.
Correct Answer is B
Explanation
Choice A rationale:
"Height and weight.”.
Rationale: While monitoring height and weight is important for a child's growth and development, these parameters are not the primary vital signs to assess dehydration.
Dehydration assessment focuses on immediate physiological indicators, such as heart rate and blood pressure.
Choice B rationale:
"Heart rate and blood pressure.”.
Rationale: This is The correct answer.
When assessing a dehydrated child, monitoring vital signs such as heart rate and blood pressure is crucial.
Dehydration can lead to an increased heart rate and decreased blood pressure.
These parameters provide valuable information about the child's circulatory status and fluid balance.
Choice C rationale:
"Hair and eye color.”.
Rationale: Hair and eye color are not relevant parameters for assessing dehydration.
They are genetic traits and do not change in response to dehydration.
Choice D rationale:
"Shoe size and clothing size.”.
Rationale: Shoe size and clothing size are not relevant for assessing dehydration.
These measurements are related to a child's growth and body structure but do not provide information about their hydration status.
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