A client presents to the emergency department complaining of several days of nausea and vomiting with weakness and dizziness. The client's vital signs are: Pulse 110, BP 88/56, RR 24, SpO2 95% on room air, temperature of 100.2. The client's lung sounds are clear bilaterally. Which of the following IV fluids would the nurse expect to administer?
Dextrose in water
6.45% Sodium Chloride
10% Dextrose in water
0.9% Sodium Chloride
The Correct Answer is D
A. Dextrose in water is typically used for hydration and to provide some calories. However, this client is presenting with hypotension (BP 88/56), tachycardia (Pulse 110), and weakness, likely due to fluid loss from vomiting. This client needs fluid resuscitation with a solution that will help restore circulating volume, and Dextrose in water does not contain sodium, which is necessary for fluid balance in this case.
B. 6.45% Sodium Chloride is a hypertonic saline solution, which would increase the osmolarity of the blood and pull fluid into the bloodstream. This would not be the first choice for this patient, as it could exacerbate dehydration and electrolyte imbalances.
C. 10% Dextrose in water is also a hypertonic solution that would provide energy but would not adequately address the client's fluid volume deficit or hypotension.
D. 0.9% Sodium Chloride is normal saline, which is an isotonic solution and is the most appropriate choice for fluid resuscitation in this client. It will help restore circulating blood volume, stabilize blood pressure, and provide the necessary hydration to address the client's symptoms of dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Skip lesions and a cobblestone appearance are characteristic of Crohn's disease, not ulcerative colitis (UC). UC involves continuous inflammation of the colon, without skip lesions.
B. Ulcerative colitis is associated with a risk for bowel perforation and toxic megacolon, which are serious complications of the disease.
C. Diarrhea containing blood is a common symptom of ulcerative colitis, as it primarily affects the colon and rectum, leading to inflammation and ulceration.
D. Increased risk for colorectal cancer is a known complication of ulcerative colitis, especially with long-term disease duration.
Correct Answer is B
Explanation
A. Orthostatic hypotension can be concerning, but it is not as immediately alarming as a very elevated WBC count. It could indicate dehydration or blood loss, which are common in Crohn's disease exacerbations, but it is not as critical as an infection or severe inflammation.
B. A WBC count of 83 (normal range is typically 4,000-11,000) is significantly elevated and suggests a severe infection or inflammatory response, which is a critical concern in Crohn's disease exacerbations. This could indicate a life-threatening complication such as an abscess or perforation.
C. Lack of appetite for 2 days is common during an exacerbation of Crohn's disease, though it can contribute to dehydration or malnutrition, it is not as immediately concerning as an elevated WBC count.
D. Abdominal cramping is a typical symptom of Crohn's disease and may worsen during exacerbations, but it is not the most concerning finding compared to a severely elevated WBC count.
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