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. Furosemide (Lasix): This is a diuretic used to treat fluid retention and does not address the symptoms related to calcium imbalances.
B. Diazepam (Valium): This is an anxiolytic and does not address the symptoms associated with hypocalcemia following a thyroidectomy.
C. Calcium gluconate: This is the appropriate medication for treating hypocalcemia, which can occur after a thyroidectomy due to potential damage to or removal of parathyroid glands, leading to symptoms such as abdominal cramping and irregular heart rate.
D. Calcitonin: While this hormone helps regulate calcium levels, it is more commonly used to treat hypercalcemia, not hypocalcemia.
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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