A client is admitted with hypovolemia due to severe bleeding. Which Intravenous fluid does the nurse anticipate using to replace fluid losses?
5% dextrose in 0.25% sodium chloride (D51/4NS)
3% sodium chloride (3% NaCl)
5% dextrose in water (DSW)
0.9% sodium chloride (0.9% NaCl)
The Correct Answer is D
D. 0.9% sodium chloride (0.9% NaCl): This solution, also known as normal saline, is isotonic and contains the same concentration of sodium as extracellular fluid. It is the most appropriate choice for initial fluid resuscitation in hypovolemia due to severe bleeding because it rapidly expands intravascular volume, replaces sodium losses, and helps restore circulating blood volume.
A. This solution contains dextrose (glucose) and a small amount of sodium chloride. It provides some glucose for energy but has a lower sodium concentration compared to isotonic solutions like normal saline. While it may be used in certain situations, such as to provide maintenance fluids or correct mild dehydration, it is not the first choice for fluid resuscitation in hypovolemia due to severe bleeding because it does not adequately replace lost volume.
B. 3% sodium chloride (3% NaCl): This solution is hypertonic and has a high sodium concentration. It is not typically used for initial fluid resuscitation in hypovolemia due to severe bleeding. Hypertonic saline solutions like 3% NaCl are more commonly used in specific situations such as severe hyponatremia or cerebral edema.
C. 5% dextrose in water (D5W): This solution contains only dextrose and water and is isotonic until the dextrose is metabolized, after which it becomes hypotonic. D5W is not suitable for fluid resuscitation in hypovolemia due to severe bleeding because it does not provide adequate sodium or volume replacement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. It's essential for nurses caring for dying patients to be comfortable with their own feelings about death and dying. Being comfortable with mortality allows nurses to provide compassionate care, support families, and engage in end-of-life discussions with patients. Nurses who are comfortable with their own feelings about death are better equipped to provide holistic care and support to dying patients and their families.
B. Hospice services focus on providing comfort and support to terminally ill patients and their families during the end-of-life journey. While hospice services are often beneficial and recommended for patients approaching the end of life, preferences vary among individuals and families. Some patients may choose to receive hospice care, while others may prefer to remain at home with palliative care support or receive care in a hospital or long-term care facility.
C. While some patients may experience pain as death nears, it is not necessarily true that "most" deaths are accompanied by significant pain. With advances in palliative care and pain management, many patients can experience a comfortable and peaceful death with effective symptom management.
D. Most people are not frightened to die if they have adequate information about what is happening: While adequate information and preparation can alleviate some fears about death, attitudes and responses to death vary widely among individuals. Some people may find comfort and acceptance in understanding the dying process and what to expect, while others may still experience fear, anxiety, or uncertainty regardless of the information provided.
Correct Answer is D
Explanation
D. In metabolic acidosis, the pH would be low (acidemic) and the HCO3 level would be below the normal range. In the provided ABG results, the pH is low (acidemic) and the HCO3 level is below the normal range, indicating metabolic acidosis.
A. In respiratory alkalosis, the pH would be elevated (alkalotic) and the PaCO2 would be below the normal range (hypocapnia). However, in the provided ABG results, the pH is low (acidemia) rather than high, ruling out respiratory alkalosis.
B. In respiratory acidosis, the pH would be low (acidemic) and the PaCO2 would be above the normal range (hypercapnia). However, in the provided ABG results, the PaCO2 is within the normal range, ruling out respiratory acidosis.
C. In metabolic alkalosis, the pH would be elevated (alkalotic) and the HCO3 level would be above the normal range. However, in the provided ABG results, the pH is low (acidemic) and the HCO3 level is below the normal range, ruling out metabolic alkalosis.
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