A nurse is preparing to provide care for a client in the emergency department who has syndrome of Inappropriate antidiuretic hormone (SIADH). The client has a serum sodium of 115 mEq/L (136-145 mEq/L). Which of the following IV solutions should the nurse anticipate will be prescribed?
3% sodium chloride
0.99% sodium chloride
Dextrose 59% in 0.99% sodium chloride
Dextrose 5% in 0.45% sodium chloride
The Correct Answer is A
A. 3% sodium chloride is a hypertonic solution used to treat severe hyponatremia by raising the serum sodium levels rapidly.
B. 0.9% sodium chloride is isotonic and would not be sufficient to correct severe hyponatremia as quickly.
C. Dextrose 5% in 0.9% sodium chloride is not typically used for severe hyponatremia treatment.
D. Dextrose 5% in 0.45% sodium chloride is hypotonic and not suitable for treating severe hyponatremia.
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Related Questions
Correct Answer is C
Explanation
A. Hypernatremia is not characteristic of SIADH; hyponatremia is more common.
B. Increased urine output is not seen in SIADH; rather, there is decreased urine output.
C. Decreased serum sodium levels (hyponatremia) are a key feature of SIADH due to excessive water retention.
D. Increased serum osmolality is not seen in SIADH; decreased serum osmolality is more characteristic.
Correct Answer is ["2.4"]
Explanation
Rationale:
To calculate the dosage of Nitroprusside in mcg/min, first convert the client's weight from pounds to kilograms, knowing that 1 kg equals 2.2 lbs. Therefore, 176 lbs is approximately 80 kg. Next, multiply the client's weight in kg by the dosage rate: 0.5 mcg/kg/min. So, 80 kg * 0.5 mcg/kg/min equals 40 mcg/min. To find mcg/hr, multiply the mcg/min dosage by 60, the number of minutes in an hour, which gives us 2400 mcg/hr. Finally, to calculate mL/hr, use the concentration of the drug: 500 mg in 500 mL. Since 1 mg equals 1000 mcg, 500 mg is 500,000 mcg. Divide the hourly dosage in mcg by the total number of mcg in the available fluid to find the mL/hr. Thus, 2400 mcg/hr divided by (500,000 mcg / 500 mL) results in 2.4 mL/hr. Rounded to the nearest tenth, the final dosages are 40 mcg/min, 2400 mcg/hr, and 2.4 mL/hr.
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