A nurse is evaluating a client for response to treatment for dehydration. Which finding indicates adequate response to isotonic fluids?
Increased respiratory rate from 12 to 22 breaths/min
Decrease in heart rate from 70 to 55 beats per minute
Increased urine specific gravity from 1.012 to 1.030 g/mL
Increased blood pressure from 96/48 to 116/68
The Correct Answer is D
Choice A reason: Increased respiratory rate from 12 to 22 breaths/min suggests worsening respiratory distress, not a response to dehydration treatment. Dehydration does not typically affect respiratory rate unless severe, and isotonic fluids correct hypovolemia, making this an incorrect indicator of adequate fluid response.
Choice B reason: A decrease in heart rate from 70 to 55 beats/min may occur with fluid replacement, but bradycardia (below 60) could indicate overhydration or electrolyte imbalances. Normal heart rate restoration is expected, but this drop is excessive, making it less reliable than blood pressure improvement.
Choice C reason: Increased urine specific gravity from 1.012 to 1.030 g/mL indicates concentrated urine, suggesting persistent dehydration. Isotonic fluids should dilute urine, lowering specific gravity toward normal (1.010–1.020 g/mL). This finding shows inadequate response, as fluid replacement should restore hydration status.
Choice D reason: Increased blood pressure from 96/48 to 116/68 indicates restored intravascular volume with isotonic fluids, correcting hypovolemia in dehydration. Normalizing blood pressure reflects improved perfusion and cardiac output, making it the best indicator of adequate response to fluid therapy, directly correlating with corrected volume status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["5"]
Explanation
Step 1 is (2 grams ÷ 10 mL) Result = 0.2 grams per mL
Step 2 is (1 gram ÷ 0.2 grams per mL) Result = 5 mL
Correct Answer is D
Explanation
Choice A reason: Lactated Ringer’s (130 mEq/L sodium) is isotonic but insufficient for severe hyponatremia (120 mEq/L). It may worsen fluid overload without rapidly raising sodium, risking neurological complications like seizures, making it inappropriate for urgent correction compared to hypertonic saline.
Choice B reason: Dextrose 5% in 0.9% sodium chloride (154 mEq/L sodium) is isotonic but inadequate for severe hyponatremia. It raises sodium slowly, risking persistent neurological symptoms. Hypertonic saline (3%) corrects sodium faster, preventing complications like cerebral edema, making this a less effective choice.
Choice C reason: 0.45% sodium chloride (77 mEq/L sodium) is hypotonic, worsening hyponatremia by diluting serum sodium. This exacerbates neurological risks like seizures in a client with 120 mEq/L, making it an incorrect choice for correcting severe hyponatremia compared to hypertonic saline.
Choice D reason: 3% sodium chloride (513 mEq/L sodium) is hypertonic, ideal for correcting severe hyponatremia (120 mEq/L). It raises sodium gradually, preventing seizures or cerebral edema. Careful administration avoids rapid correction risks like osmotic demyelination, making it the appropriate choice for this client’s condition.
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