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. Re-lubricating the tubing and re-inserting it is unnecessary if the enema solution is not infusing; the primary issue is likely related to the tubing's position or the height of the container.
B. Inserting the tubing an additional three inches into the rectum ensures that it is positioned correctly for the solution to flow. If the tubing is not inserted far enough, the solution may not enter the rectum.
C. Raising the saline container higher is not needed since it is already six inches above the client’s body. The problem is more likely related to the tubing’s depth rather than the height of the container.
D. Instructing the client to take deep breaths does not affect the infusion of the enema solution. The solution's flow is influenced by the mechanics of the enema administration, not by the client’s breathing.
Correct Answer is D
Explanation
A. Assigning the UAP to more stable clients does not address the immediate issue of the protocol omission and does not ensure that the protocol is followed correctly in the future.
B. Completing an unusual occurrence report is not necessary if the omission was corrected and the situation does not involve a significant error or safety issue.
C. Reporting to the charge nurse may be appropriate, but the priority is to ensure the UAP understands and follows the protocol, which is best achieved through direct supervision.
D. Supervising the UAP and reviewing the protocol ensures that the UAP understands and adheres to the fall prevention protocol moving forward, addressing both the immediate issue and future adherence.
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