Exhibits
The practical nurse (PN) notifies the healthcare provider that the client continues to have signs of fluid volume deficit. The health care provider prescribes a continuous infusion of isotonic fluids.
Which fluid(s) is/are classified as isotonic? Select all that apply.
50% dextrose
0.45% sodium chloride
20% dextrose
5% dextrose
5% dextrose with 0.45% sodium chloride
5% dextrose with lactated Ringer's
lactated Ringer's
0.9% sodium chloride
Correct Answer : G,H
A. 50% dextrose
50% dextrose is not isotonic; it is a hypertonic solution. Hypertonic solutions have a higher concentration of solutes compared to the cells, causing water to move out of the cells and into the extracellular space, which does not treat fluid volume deficit effectively.
B. 0.45% sodium chloride
0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution. Hypotonic solutions have a lower concentration of solutes compared to the cells, which would cause water to move into the cells rather than stay in the extracellular space to address fluid volume deficit.
C. 20% dextrose
20% dextrose is a hypertonic solution. It contains a higher concentration of dextrose compared to the extracellular fluid, which draws water into the extracellular space but is not used for treating fluid volume deficits.
D. 5% dextrose
5% dextrose (D5W) is initially isotonic but becomes hypotonic once metabolized, as the dextrose is used up and only water remains. It is not suitable for continuous isotonic fluid therapy for fluid volume deficit.
E. 5% dextrose with 0.45% sodium chloride
5% dextrose with 0.45% sodium chloride is a hypertonic solution. While it starts isotonic, it becomes hypotonic once the dextrose is metabolized, making it unsuitable for long-term isotonic fluid replacement.
F. 5% dextrose with lactated Ringer's
5% dextrose with lactated Ringer's is a hypertonic solution. It contains both dextrose and electrolytes, which are not purely isotonic and may not be ideal for addressing fluid volume deficits on their own.
G. Lactated Ringer's
Lactated Ringer's is an isotonic solution. It has a similar osmolarity to plasma and is used for fluid volume replacement, helping to restore blood volume and maintain electrolyte balance.
H. 0.9% sodium chloride
0.9% sodium chloride, or normal saline, is an isotonic solution. It has the same osmolarity as plasma and is commonly used for fluid volume replacement and maintaining hydration
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Measure urinary output.
Measuring urinary output is important for monitoring fluid balance but is not the most critical intervention for assessing left-sided heart failure specifically.
B. Auscultate all lung fields.
Auscultating lung fields is crucial for assessing signs of pulmonary edema, a key symptom of left-sided heart failure. It provides direct information about the severity of the condition and guides further management.
C. Check mental acuity.
Checking mental acuity can be useful but is not the most critical intervention for managing left-sided heart failure. It is less directly related to evaluating the severity of heart failure compared to lung auscultation.
D. Inspect for sacral edema.
Inspecting for sacral edema is more relevant for right-sided heart failure. For left-sided heart failure, the priority is evaluating pulmonary symptoms, not peripheral edema.
Correct Answer is ["A","D","E"]
Explanation
A. Place the drink where the client can reach from her bed
Placing the drink where the client can easily reach it encourages regular fluid intake. Accessibility is key for clients who may be feeling weak or fatigued, especially when dealing with symptoms of illness like fever and cough. Ensuring that fluids are within reach minimizes barriers to drinking and supports better hydration efforts.
B. Encourage drinks with high sugar content
Drinks with high sugar content are not ideal for promoting adequate fluid intake. High sugar content can worsen symptoms like nausea or dehydration and may lead to increased thirst or gastrointestinal upset, which is counterproductive to encouraging fluid intake. Offering fluids with balanced electrolytes and moderate sugar content is more beneficial.
C. Only offer water or other clear drink
Offering only water or clear drinks can be too restrictive and may not meet the client's preferences or needs. While clear liquids are appropriate, incorporating a variety of fluids can improve hydration and patient satisfaction. It is beneficial to offer options that the client might find appealing.
D. Ask the client what her favorite drink is
Asking the client for her favorite drink engages her in the decision-making process and increases the likelihood of her consuming more fluids. Personal preferences can significantly affect fluid intake, and offering drinks she likes can help in achieving adequate hydration.
E. Offer both hot and cold drinks
Offering both hot and cold drinks can cater to the client’s preferences and provide comfort, which may encourage her to drink more fluids. Variety in temperature can make drinking fluids more appealing, especially if the client is feeling unwell or has specific preferences.
F. Suggest popular drinks like coffee or soda
Suggesting coffee or soda is not recommended due to their diuretic effects and potential for dehydration. Coffee and soda can also interfere with electrolyte balance and are generally not suitable for hydration in a clinical setting where the goal is to address fluid volume deficit
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