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 ["B","C","D"]
Explanation
Choice A rationale:
Lactated Ringer's solution is not contraindicated in cases of hyperkalemia.
This solution contains potassium in a relatively low concentration of 4 mEq/L, which is unlikely to significantly impact hyperkalemia.
Choice B rationale:
Lactated Ringer's solution can be contraindicated in cases of hypokalemia.
While it does contain potassium, the concentration is relatively low at 4 mEq/L.
In cases of severe hypokalemia, a more potassium-rich solution might be preferred.
Choice C rationale:
Lactated Ringer's solution can be used in cases of lower GI fluid loss.
It can help replace lost fluids and electrolytes effectively.
Choice D rationale:
Lactated Ringer's solution can be used in cases of upper GI fluid loss.
It helps restore lost fluids and electrolytes.
Choice E rationale:
Lactated Ringer's solution is not contraindicated in cases of lactic acidosis.
In fact, it contains lactate (28 mEq/L), which can be metabolized to bicarbonate and help correct acidosis.
Correct Answer is A
Explanation
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.
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