The nurse is preparing a client for an echocardiogram. The client asks what the test can show Which of the following is a correct statement?

A) "5% Dextrose in water (D5W)":
. D5W is an isotonic solution that, once metabolized by the body, becomes hypotonic because the glucose is rapidly utilized, leaving water. It is typically used to provide free water for hydration or for patients who need a small amount of calories or fluid, but it is not the best choice for this client. The client's low blood pressure and symptoms of dehydration (nausea, vomiting, dizziness, and weakness) suggest that normal saline (0.9% sodium chloride) is the more appropriate choice to help restore circulatory volume and improve blood pressure.

B) "10% Dextrose in water (D10W)":
. D10W is a hypertonic solution with a higher concentration of glucose, used in specific situations such as severe hypoglycemia or for patients requiring a high amount of glucose. It is not appropriate for this patient, whose primary issue seems to be volume depletion due to nausea and vomiting. The focus should be on replenishing circulatory volume and addressing the hypotension, which normal saline (0.9% sodium chloride) would do more effectively than D10W.

C) "0.9% Sodium Chloride":
. 0.9% Sodium Chloride (normal saline) is an isotonic solution and is the most appropriate choice for fluid resuscitation in a client with low blood pressure (hypotension) and signs of dehydration (nausea, vomiting, dizziness). This solution will help restore circulatory volume, correct hypovolemia, and improve blood pressure. It is commonly used for initial fluid resuscitation in clients who are hypotensive and experiencing fluid loss due to vomiting.

D) "0.45% Sodium Chloride (half-normal saline)":
. 0.45% Sodium Chloride is a hypotonic solution, which is more appropriate for treating patients who have conditions like hypernatremia or require gradual hydration. However, in this case, the patient is presenting with hypotension, dizziness, and weakness, which are signs of fluid depletion. A hypotonic solution would not be appropriate in this context, as it could potentially worsen the patient's hypotension or lead to further fluid shifts. The focus should be on using normal saline (0.9% sodium chloride) to help restore circulatory volume and improve the low blood pressure.

A) "Increased viral load":
An increased viral load would indicate that the HIV virus is actively replicating in the body. This suggests that the antiretroviral therapy (ART) is not effective, as it has failed to suppress the viral replication. The goal of ART is to lower the viral load to undetectable levels, indicating that the virus is well controlled.

B) "Decreased neutrophil count":
. A decreased neutrophil count (neutropenia) is not directly related to the effectiveness of ART in managing HIV. Neutropenia can occur due to various causes, such as certain medications (including some ART medications), infections, or other underlying conditions. While neutropenia could be a side effect of ART, it does not directly reflect the effectiveness of HIV treatment. Monitoring CD4-T-cell counts and viral load is a better indicator of ART effectiveness.

C) "Decreased white blood cell count":
. A decreased white blood cell count (leukopenia) is also not an indicator of ART effectiveness. While some ART medications may lead to a decrease in white blood cell count, especially in the early stages of treatment, a decrease in the white blood cell count is not a measure of how well the therapy is controlling HIV. The effectiveness of ART is primarily assessed by the viral load and CD4-T-cell count.

D) "Increased CD4-T-cell count":
. CD4-T-cell count is a critical marker for monitoring the immune system's function in patients with HIV. CD4-T-cells are a type of T lymphocyte (white blood cell) that are targeted and destroyed by the HIV virus. A higher CD4-T-cell count indicates that the immune system is recovering and functioning better, which is a sign that the ART is effective in controlling the virus. Ideally, ART should result in a higher CD4-T-cell count and lower viral load, showing that the treatment is effectively suppressing the virus and preserving the immune system.