A nurse is caring for a client who has suffered acute blood loss and is experiencing hypovolemia due to third-space fluid shifts.
The physician orders Lactated Ringer’s solution for fluid resuscitation.
The nurse knows that this solution contains Sodium 130 mEq/L, Chloride 109 mEq/L, Potassium 4 mEq/L, Calcium 3 mEq/L, and Lactate 28 mEq/L.
Which of the following statements are true regarding Lactated Ringer’s solution? (Select all that apply).

Sunken fontanelle (in infants).

C. Dry mucous membranes.

E. Lethargy.

Choice A rationale:

Sunken fontanelle (in infants) is a clinical sign of dehydration.

The fontanelle is the soft spot on an infant's head, and when it becomes sunken, it suggests that the child is dehydrated.

This occurs because a lack of adequate fluid causes the brain to temporarily shrink, leading to the sunken appearance.

Choice B rationale:

Increased urine output is not typically a sign of dehydration.

In fact, dehydration often leads to decreased urine output as the body attempts to conserve fluid.

Increased urine output can be a sign of other conditions, such as diabetes.

Choice C rationale:

Dry mucous membranes are a classic sign of dehydration.

When the body lacks sufficient fluids, the mucous membranes in the mouth and other areas can become dry and sticky.

This is an important clinical indicator of dehydration.

Choice D rationale:

Normal skin turgor is not a sign of dehydration.

Skin turgor refers to the skin's ability to bounce back when pinched and released.

In a hydrated individual, the skin should have good turgor.

Dehydration can lead to poor skin turgor, but normal skin turgor does not indicate dehydration.

Choice E rationale:

Lethargy is a potential sign of dehydration.

When a child is dehydrated, they may become lethargic or unusually tired because their body is not receiving the necessary fluids to function properly.

Lethargy can be an early sign of dehydration in children.

Choice A rationale:

Lactated Ringer's solution is not contraindicated in cases of hyperkalemia.

This solution contains potassium in a relatively low concentration of 4 mEq/L, which is unlikely to significantly impact hyperkalemia.

Choice B rationale:

Lactated Ringer's solution can be contraindicated in cases of hypokalemia.

While it does contain potassium, the concentration is relatively low at 4 mEq/L.

In cases of severe hypokalemia, a more potassium-rich solution might be preferred.

Choice C rationale:

Lactated Ringer's solution can be used in cases of lower GI fluid loss.

It can help replace lost fluids and electrolytes effectively.

Choice D rationale:

Lactated Ringer's solution can be used in cases of upper GI fluid loss.

It helps restore lost fluids and electrolytes.

Choice E rationale:

Lactated Ringer's solution is not contraindicated in cases of lactic acidosis.

In fact, it contains lactate (28 mEq/L), which can be metabolized to bicarbonate and help correct acidosis.