A client is admitted to the hospital with hypoalbuminemia and shock.
The nurse is preparing to start an intravenous (IV) infusion.
Which of the following IV fluids is the most appropriate for this client?
Albumin (5% or 25%).
Dextrans (Dextran-40 or Dextran-70).
Gelatin (Gelofusine or Haemaccel).
Plasma protein fraction (Plasmanate or Plasmasteril).
The Correct Answer is A
Choice A rationale:
Albumin (5% or 25%) Albumin is the most appropriate IV fluid for a client with hypoalbuminemia and shock.
Albumin is a colloid solution that helps to increase oncotic pressure, which can be decreased in conditions like hypoalbuminemia.
This increased oncotic pressure can help draw fluids back into the vascular space, improving intravascular volume and blood pressure.
Therefore, it is a suitable choice for a patient with shock.
The two concentrations mentioned, 5% and 25%, refer to the percentage of albumin in the solution, and the choice between them depends on the severity of the patient's condition and the desired effect.
The 5% solution is often used for volume expansion and to improve hemodynamics, while the 25% solution is used for rapid volume expansion.
Choice B rationale:
Dextrans (Dextran-40 or Dextran-70) Dextrans are another type of colloid solution, but they are not the best choice for this specific situation.
Dextrans are often used as volume expanders but are more commonly employed in conditions where there is no issue with albumin levels.
In this case, the primary concern is hypoalbuminemia, and using albumin-based solutions would be more appropriate.
Choice C rationale:
Gelatin (Gelofusine or Haemaccel) Gelatin-based solutions are also colloids and can be used for volume expansion.
However, they are not the best choice for a patient with hypoalbuminemia because they do not address the low albumin levels.
Albumin solutions are preferred in such cases to help restore oncotic pressure and improve intravascular volume.
Choice D rationale:
Plasma protein fraction (Plasmanate or Plasmasteril) Plasma protein fraction solutions, also known as human albumin, are similar to albumin solutions.
However, in this context, albumin solutions are more commonly used.
Plasma protein fraction solutions may be indicated in specific situations, but the primary choice for a patient with hypoalbuminemia and shock would be albumin-based solutions, as they are specifically designed to address albumin deficiencies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Gastrointestinal illnesses, particularly diarrhea and vomiting, lead to fluid loss from the body.
Diarrhea can cause significant loss of water and electrolytes, leading to dehydration.
Vomiting, especially when persistent, can also result in fluid depletion.
These conditions are common causes of dehydration in both children and adults.
Choice B rationale:
Excessive sweating during physical activity or in hot weather can lead to dehydration in individuals, but this scenario does not apply to the child described in the question, who is experiencing decreased urine output and dark-colored urine.
Sweating excessively is more common in older children and adults during physical activities.
Choice C rationale:
Fever, which increases the body's fluid requirements, is a valid point.
However, the child in this scenario does not have fever mentioned as a symptom.
In the absence of fever, gastrointestinal illnesses are the more likely cause of dehydration.
Choice D rationale:
Certain medical conditions, such as diabetes or kidney disease, can lead to chronic dehydration.
However, these conditions are not mentioned in the scenario provided.
In the absence of information about underlying medical conditions, gastrointestinal illnesses remain the most likely cause of the child's dehydration.
Correct Answer is D
Explanation
Choice A rationale:
Ensure appropriate fluid intake based on age and weight.
Rationale: This is an essential piece of advice to prevent dehydration in children.
Proper fluid intake based on age and weight helps maintain hydration.
However, it's not the only advice that should be given.
Choice B rationale:
Monitor for signs of dehydration such as dry mucous membranes and decreased urine output.
Rationale: Monitoring for signs of dehydration is crucial, but it's not the only preventive measure.
Detecting dehydration early is important for timely intervention, but proactive prevention is also necessary.
Choice C rationale:
Encourage consumption of electrolyte solutions during periods of illness.
Rationale: Encouraging the consumption of electrolyte solutions during illness is a valuable piece of advice, especially when children may lose fluids due to vomiting or diarrhea.
However, it's not the only preventive measure.
Choice D rationale:
All these measures are necessary to prevent dehydration in children.
Rationale: This is The correct answer.
Preventing dehydration in children involves a combination of measures, including ensuring appropriate fluid intake, monitoring for signs of dehydration, and encouraging electrolyte solutions during illness.
All these measures work together to keep a child well-hydrated and prevent dehydration.
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