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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).

Lactated Ringer’s solution is contraindicated in cases of hyperkalemia.

Lactated Ringer’s solution is contraindicated in cases of hypokalemia.

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

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

Lactated Ringer’s solution is contraindicated in cases of lactic acidosis.

Answer and Explanation

Correct Answer : B,C,D

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.

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Correct Answer is D

Explanation

The correct answer is Choice B: Total maintenance fluids = 1200 mL/day.

Choice A rationale:

This value exceeds the calculated requirement for a child weighing 18 kg using the Holliday-Segar method.

Choice B rationale:

The Holliday-Segar method calculates maintenance fluids based on weight as follows:

For the first 10 kg, the requirement is 100 mL/kg.
For the next 10 kg, the requirement is 50 mL/kg.

Thus, for a child weighing 18 kg:

First 10 kg: 10 kg x 100 mL/kg = 1000 mL
Next 8 kg: 8 kg x 50 mL/kg = 400 mL Total maintenance fluid requirement = 1000 mL + 400 mL = 1400 mL/day.

So, actually, the correct answer should be Choice D: 1400 mL/day.

Choice C rationale:

This value is higher than the requirement for 18 kg based on the Holliday-Segar method.

Choice D rationale:

This is the correct calculation based on the method described above: 1000 mL for the first 10 kg plus 400 mL for the next 8 kg totals 1400 mL/day.

A. “This IV fluid will provide me with hydration and calories.”. B. “This IV fluid will help lower my blood sugar levels.”. C. “This IV fluid will provide me with essential electrolytes.”. D. “This IV fluid will help increase my blood pressure.”..

Correct Answer is A

Explanation

Choice A rationale:

The client's statement, "This IV fluid will provide me with hydration and calories," is correct.

D10W contains 10% dextrose and is used to provide both hydration and calories to the patient.

Choice B rationale:

D10W would not help lower blood sugar levels.

In fact, it would increase blood sugar levels due to the high concentration of dextrose.

Choice C rationale:

D10W does not provide essential electrolytes, so the statement is incorrect.

It's primarily used for calorie supplementation and hydration.

Choice D rationale:

D10W would not help increase blood pressure.

While it can provide hydration, it does not contain medications or components specifically intended to increase blood pressure.

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Naxlex Comprehensive Predictor Exams

A nurse is calculating maintenance fluids for a child who weighs 18 kg. According to the Holliday-Segar method, what would be the total maintenance fluid requirement for this child?

Correct Answer is D

Explanation

A client is about to receive D10W (10% dextrose in water) as part of their treatment plan.The nurse explains that this intravenous fluid contains Dextrose 100 g/L and Water 900 mL.Which of the following statements made by the client indicates a correct understanding of their treatment?

Correct Answer is A

Explanation

A nurse is providing interventions for a dehydrated child.Select all appropriate nursing interventions from the following options (A-E).

A nurse is assessing a child for dehydration.Select all the clinical manifestations of dehydration in children mentioned in the text.

A nurse is caring for a child with severe dehydration who weighs 14 kg.What would be the total hourly fluid replacement rate for this child?

A client’s parent asks a nurse about how they can prevent their child from becoming dehydrated again in future.Which of the following advice should be given by the nurse?

A nurse is preparing to calculate fluid replacement for a dehydrated child.Which of the following steps should the nurse take? (Select all that apply).

A nurse is providing fluid replacement therapy to a dehydrated child.What should the nurse do to ensure comprehensive care during the treatment and management of dehydration in children?

A client is admitted to the hospital with hypoalbuminemia and shock.The nurse is preparing to start an intravenous (IV) infusion.Which of the following IV fluids is the most appropriate for this client?

A client brings their child to the pediatric clinic, concerned about dehydration.The child has been experiencing decreased urine output and dark-colored urine.What etiological factors could contribute to the child's dehydration, as discussed in the text?