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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Poorly controlled pain, moves all extremities, reports continued nausea: Poorly controlled pain and nausea are not ideal for discharge, as they indicate the patient might need further monitoring and management.
B. 2-hour total urinary output of 30 mL, pulse oximetry 94% on 3L oxygen, turning from side to side: Low urinary output and low oxygen saturation indicate potential complications that require further assessment and treatment.
C. Afebrile, adventitious breath sounds, responds to painful stimuli: Responding to painful stimuli and adventitious breath sounds suggest the patient may still be experiencing complications and is not ready for discharge.
D. SaO2 of 95%, vital signs stable for last 30 minutes, active gag reflex: This response indicates stable oxygen saturation, stable vital signs, and an active gag reflex, suggesting the patient is ready for discharge from the PACU.
Correct Answer is C
Explanation
A. Capillary refill and depth of peripheral edema: While these assessments are important for evaluating peripheral circulation and fluid status, they are not as immediately critical given the client's new onset of confusion and respiratory symptoms.
B. Abdominal sounds and obtain a BNP level: Assessing abdominal sounds and BNP (B-type natriuretic peptide) levels is useful for diagnosing heart failure exacerbations but is secondary to addressing the client's acute confusion and potential electrolyte imbalances.
C. Neurological status and obtain electrolyte levels: This is the correct choice. New onset confusion can be indicative of electrolyte imbalances or acute exacerbations related to heart failure. Monitoring neurological status and electrolyte levels is crucial to address potential causes of confusion and ensure proper treatment.
D. Skin turgor and measure intake & output (I&O): While skin turgor and I&O are relevant for assessing fluid status, the priority should be addressing the acute change in mental status and potential underlying causes such as electrolyte imbalances.
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