A patient presents to the emergency department with reports of vomiting and diarrhea for the past 48 hours. The health care provider orders isotonic intravenous (IV) therapy. Which IV will the nurse prepare?

0.225% sodium chloride (1/4 NS)

0.45% sodium chloride (1/2 NS)

0.9% sodium chloride (NS)

3% sodium chloride (3% NaCl)

Answer and Explanation

The Correct Answer is C

A. 0.225% sodium chloride (1/4 NS): This hypotonic solution can shift fluids into cells but is not ideal for isotonic therapy. It may cause fluid imbalance and not restore extracellular fluid balance effectively in vomiting and diarrhea.

B. 0.45% sodium chloride (1/2 NS): This is another hypotonic solution that may cause fluid shifts into the cells. It is not isotonic, making it less appropriate for fluid replacement in this case.

C. 0.9% sodium chloride (NS): Normal saline is an isotonic solution that closely matches the osmolality of body fluids. It is the best choice to replace extracellular fluid lost from vomiting and diarrhea.

D. 3% sodium chloride (3% NaCl): This hypertonic solution is used for severe hyponatremia and shifts fluids out of cells. It is inappropriate for fluid replacement in vomiting and diarrhea, as it could lead to fluid overload.

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Correct Answer is A

Explanation

A. Respiratory acidosis: Oxycodone, an opioid, can depress the respiratory system, leading to hypoventilation. Reduced breathing leads to the accumulation of carbon dioxide (CO2) in the blood, causing respiratory acidosis, characterized by low pH due to increased CO2 levels.

B. Metabolic acidosis: Metabolic acidosis occurs when there is an accumulation of acid or a loss of bicarbonate in the body. It is not directly associated with opioid overdose, which primarily affects respiratory function rather than metabolic processes.

C. Respiratory alkalosis: Respiratory alkalosis happens when excessive CO2 is exhaled, often due to hyperventilation. This is not typical in opioid overdose, where respiratory depression leads to hypoventilation and CO2 retention, not excess loss.

D. Metabolic alkalosis: Metabolic alkalosis results from excessive loss of acid or retention of bicarbonate, often due to vomiting or diuretic use. Opioid overdose typically leads to respiratory acidosis, not metabolic alkalosis.

A. Tenderness at the IV site B. Urine specific gravity is 1.018 C. Capillary refill is < 3 seconds D. Newly noted crackles in the lungs

Correct Answer is D

Explanation

A. Tenderness at the IV site: Tenderness at the IV site could indicate irritation or minor inflammation, but it is not the most concerning finding in this situation. It is a common issue with IV therapy and does not indicate a life-threatening condition.

B. Urine specific gravity is 1.018: A urine specific gravity of 1.018 is within the normal range (1.005 to 1.030), indicating adequate hydration. This is not an alarming finding in the context of IV fluid infusion.

C. Capillary refill is < 3 seconds: A capillary refill time of less than 3 seconds indicates good peripheral circulation, which is a positive sign and does not raise immediate concern regarding fluid status or complications from the IV infusion.

D. Newly noted crackles in the lungs: Crackles in the lungs can indicate fluid overload, which is a serious concern in older adults, particularly when receiving IV fluids like 0.45% normal saline. This suggests that the body is struggling to manage the fluid volume, leading to pulmonary complications.

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A patient presents to the emergency department with reports of vomiting and diarrhea for the past 48 hours. The health care provider orders isotonic intravenous (IV) therapy. Which IV will the nurse prepare?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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