The physician has ordered replacement fluids for a client who has a fluid volume deficit with a diagnosis of gastroenteritis. The nurse would expect the use of which type of fluids initially upon admission?
Isotonic
Hypotonic
Hypertonic
Colloid
The Correct Answer is A
A. Isotonic: Isotonic fluids have a similar osmolarity to extracellular fluid and are often used for volume replacement in clients with fluid volume deficits, such as those with gastroenteritis. Isotonic fluids help to expand intravascular volume without causing significant shifts in fluid and electrolyte balance.
B. Hypotonic: Hypotonic fluids have a lower osmolarity than extracellular fluid and are typically used to rehydrate cells in cases of cellular dehydration. While hypotonic fluids can replenish intracellular volume, they are not typically used as initial replacement fluids for clients with fluid volume deficits, especially if there is risk of exacerbating extracellular fluid deficit.
C. Hypertonic: Hypertonic fluids have a higher osmolarity than extracellular fluid and are often used to expand intravascular volume in specific situations, such as severe hyponatremia or hypovolemic shock. However, they are not typically used as initial replacement fluids for clients with gastroenteritis and fluid volume deficits.
D. Colloid: Colloids are solutions containing large molecules, such as albumin or starches, which remain within the vascular space and exert oncotic pressure to draw fluid into the intravascular compartment. While colloids may be used in some cases of severe volume deficit, they are not typically used as initial replacement fluids for clients with gastroenteritis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The client should not be asked about religion or spirituality: This option is not appropriate. Religion and spirituality are important aspects of holistic care and should be addressed based on the client's preferences and needs. Avoiding discussions about religion or spirituality based on the client's statement may overlook opportunities for supportive care.
B. The client has abandoned religion due to illness: There is no evidence to suggest that the client has abandoned religion due to illness based solely on the statement provided. Assuming such a conclusion without further assessment would be inappropriate and potentially inaccurate.
C. The client could be interviewed about personal experiences that guide their life: This is the correct interpretation. The client's statement indicates that they identify as spiritual but do not adhere to a specific religious denomination. This suggests that the client may have personal beliefs, values, or experiences that guide their life and worldview. The nurse can explore these aspects through open-ended questions to gain insight into the client's spiritual needs and preferences.
D. The client does not believe in a higher power: There is no indication from the client's statement that they do not believe in a higher power. The statement simply suggests that the client does not affiliate with a specific religious denomination, but it does not necessarily imply atheism or disbelief in a higher power.
Correct Answer is C
Explanation
A. Polyuria: Polyuria refers to abnormally large volume of urine output, typically exceeding 2.5 to 3 liters per day in adults. It is often associated with conditions such as diabetes mellitus, diabetes insipidus, or certain medications that increase urine production. Urinating 250 mL over 24 hours does not meet the criteria for polyuria.
B. Retention: Urinary retention refers to the inability to completely empty the bladder, leading to accumulation of urine. It is characterized by difficulty initiating urination or incomplete bladder emptying. Urinating 250 mL over 24 hours does not indicate urinary retention.
C. Oliguria: Oliguria is defined as diminished urine output, typically less than 400 mL per day in adults. It is a common sign of kidney dysfunction or acute kidney injury. Urinating 250 mL over 24 hours falls within the range of oliguria, indicating decreased urine production compared to normal.
D. Anuria: Anuria is the absence of urine production or excretion, typically defined as urine output less than 100 mL per day. It is often indicative of severe kidney dysfunction, renal failure, or obstruction of the urinary tract. While the client's urine output of 250 mL over 24 hours is low, it does not meet the criteria for anuria.
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