A client with dry skin and mucous membranes is weak, has orthostatic blood pressure changes, and has decreased urine output. The serum osmolality is 290 mOsm/kg. What IV fluid should the nurse anticipate being prescribed for this client?
0.45% Sodium Chloride
10% dextrose in water
5% dextrose in water
0.9% Sodium Chloride
The Correct Answer is D
A. 0.45% Sodium Chloride: This is a hypotonic solution, which is not appropriate for a client with normal serum osmolality (290 mOsm/kg). It may cause fluid shifts that are not desirable in this context.
B. 10% dextrose in water: This hypertonic solution is generally used for providing calories rather than correcting fluid imbalance and is not suitable for initial rehydration in this scenario.
C. 5% dextrose in water: This solution is isotonic in the bag but becomes hypotonic in the body. It is not the best choice for rehydrating a client with normal serum osmolality and significant fluid loss.
D. 0.9% Sodium Chloride: This isotonic solution is appropriate for rehydration in a client with normal serum osmolality. It helps restore extracellular fluid volume without causing fluid shifts, making it ideal for this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Abdomen soft, surgical dressing has scant amount of old drainage: A soft abdomen and minimal old drainage from the surgical dressing are expected findings postoperatively. They do not indicate an immediate concern that requires prompt action.
B. Client ambulating with minimal assistance, complaints of occasional nausea: Ambulation and occasional nausea are common and generally expected postoperatively. These findings do not require urgent collaboration with the healthcare provider.
C. Crackles bilaterally in bases of lungs, has incisional pain: Crackles in the lungs can indicate fluid accumulation or atelectasis, which may lead to pneumonia or other respiratory complications. This finding, especially combined with recent surgery, requires prompt evaluation and intervention.
D. Temperature 99.4°F (37.4°C), pulse 100 bpm, bowel sounds present: A slightly elevated temperature and increased pulse are common after surgery. The presence of bowel sounds is a positive sign indicating the return of gastrointestinal function. These findings are not immediately concerning.
Correct Answer is A
Explanation
A. Kayexalate (sodium polystyrene): This is the correct choice. Kayexalate is used to treat hyperkalemia (high serum potassium levels) by facilitating the removal of excess potassium from the body through the gastrointestinal tract.
B. Potassium chloride: This is used to treat hypokalemia (low potassium levels), not hyperkalemia.
C. Sodium bicarbonate: This can be used to correct metabolic acidosis and may indirectly help with potassium levels, but it is not the primary treatment for hyperkalemia.
D. Aldactone (spironolactone): This is a potassium-sparing diuretic that can increase potassium levels, which would be contraindicated in the case of hyperkalemia.
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