A client is admitted with hypovolemia due to severe bleeding. Which IV fluid does the nurse anticipate using to replace fluid losses?

5% dextrose in water (D5W).

5% dextrose in 0.25% sodium chloride (D5 1/4 NS).

0.9% normal saline (0.9% NaCl).

3% sodium chloride (3% NaCl).

Answer and Explanation

The Correct Answer is C

Choice A reason:

5% dextrose in water (D5W) is not typically used for fluid resuscitation in cases of hypovolemia due to severe bleeding. D5W is a hypotonic solution once the dextrose is metabolized, which means it does not remain in the intravascular space and is not effective in expanding blood volume. It is more commonly used for providing free water and calories.

Choice B reason:

5% dextrose in 0.25% sodium chloride (D5 1/4 NS) is also not suitable for fluid resuscitation in hypovolemia due to severe bleeding. This solution is hypotonic and will not adequately expand the intravascular volume. It is generally used for maintenance fluids rather than for resuscitation.

Choice C reason:

0.9% normal saline (0.9% NaCl) is the preferred choice for fluid resuscitation in hypovolemia due to severe bleeding. It is an isotonic solution, meaning it has the same osmolarity as blood and remains in the intravascular space, effectively expanding blood volume. This helps to restore circulating volume and improve tissue perfusion.

Choice D reason:

3% sodium chloride (3% NaCl) is a hypertonic solution and is not typically used for fluid resuscitation in hypovolemia due to severe bleeding. Hypertonic solutions can cause rapid shifts of fluid from the intracellular to the extracellular space, which can lead to complications such as hypernatremia and osmotic demyelination syndrome. It is generally reserved for specific situations such as severe hyponatremia.

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Correct Answer is ["0.5"]

Explanation

Step 1: Convert the prescribed dose from mcg to mg.

235 mcg ÷ 1000 = 0.235 mg

Step 2: Determine the strength of the available tablet.

Available strength = 0.5 mg per tablet

Step 3: Calculate the number of tablets needed.

Number of tablets = 0.235 mg ÷ 0.5 mg/tablet

Step 4: Perform the division.

0.235 ÷ 0.5 = 0.47

Step 5: Round the answer to the nearest tenth.

0.47 rounded to the nearest tenth = 0.5

A. A 36-year-old male who had a minimally invasive appendectomy. The patient had community-acquired pneumonia a year ago. B. A 58-year-old female with a history of type 1 diabetes. The patient had an incision and drainage of an abscess with procedural sedation. C. A 19-year-old male having arthroscopic knee surgery under regional anesthesia. The patient has a history of exercise-induced asthma. D. A 65-year-old female who has a BMI of 32 and a long history of tobacco use. The patient had upper abdominal surgery under general anesthesia.

Correct Answer is D

Explanation

Choice A reason:

A 36-year-old male who had a minimally invasive appendectomy and a history of community-acquired pneumonia a year ago is at relatively low risk for postoperative respiratory complications. Minimally invasive surgeries typically have fewer complications, and a past episode of pneumonia does not significantly increase the risk unless there are ongoing respiratory issues.

Choice B reason:

A 58-year-old female with type 1 diabetes who had an incision and drainage of an abscess with procedural sedation has some risk factors for complications, such as diabetes, which can impair healing and immune response. However, the procedure was minor and performed under sedation, which poses less risk compared to general anesthesia.

Choice C reason:

A 19-year-old male undergoing arthroscopic knee surgery under regional anesthesia with a history of exercise-induced asthma has a low risk of respiratory complications. Regional anesthesia does not affect the respiratory system as much as general anesthesia, and exercise-induced asthma is generally well-controlled and less likely to cause complications in this context.

Choice D reason:

A 65-year-old female with a BMI of 32 and a long history of tobacco use who underwent upper abdominal surgery under general anesthesia is at the greatest risk for respiratory complications. Factors such as advanced age, obesity, smoking history, and the type of surgery (upper abdominal) significantly increase the risk of postoperative pulmonary complications. General anesthesia further exacerbates this risk due to its effects on respiratory function.

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A client is admitted with hypovolemia due to severe bleeding. Which IV fluid does the nurse anticipate using to replace fluid losses?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client prescribed drug N 235 mcg PO daily. Available is drug N PO 0.5 mg per 1 scored tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.5"]

Explanation

Which of the following postoperative patients is at greatest risk for respiratory complications?

Correct Answer is D

Explanation

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