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Which of the following statements regarding hypertonic (3%) sodium chloride is correct?

A.

Hypertonic fluids are contraindicated in patients with cerebral edema.

B.

Hypertonic saline may be administered to shift fluid out of brain tissue.

C.

Hypertonic saline is most often used for clients in hypernatremia.

D.

Hypertonic fluids are administered to promote increased brain tissue hydration.

Answer and Explanation

The Correct Answer is B

A. Hypertonic fluids are not contraindicated in patients with cerebral edema. In fact, they are often used to reduce cerebral swelling by drawing fluid out of the brain tissue into the bloodstream.  
B. Hypertonic saline (3%) is used to shift fluid out of brain tissue in conditions such as cerebral edema. It creates an osmotic gradient, pulling water from the intracellular space into the extracellular and vascular compartments, reducing intracranial pressure.  
C. Hypertonic saline is not used for clients with hypernatremia because it would exacerbate the condition by further increasing sodium levels.  
D. Hypertonic fluids do not promote hydration of brain tissue. Instead, they work to reduce excess fluid in the brain by creating an osmotic effect.  
 


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Related Questions

Correct Answer is ["C","E"]

Explanation

A. Applying a constricting bandage/gauze wrap is contraindicated. This could further compromise circulation and exacerbate ischemia.
B. Advising the client about an immediate amputation is inappropriate and outside the nurse's scope of practice. The focus should be on timely intervention and notifying the surgeon.
C. Preparing the client to go back to the operating room is appropriate because the symptoms indicate potential compartment syndrome or vascular compromise, which often requires surgical intervention to restore circulation.
D. Elevating the extremity and applying ice is contraindicated in this scenario. Elevation can further decrease blood flow to an already ischemic limb, and ice application can cause vasoconstriction, worsening the issue.
E. Notifying the surgeon is essential. The described symptoms are a surgical emergency requiring immediate evaluation and intervention to prevent permanent damage.

Correct Answer is ["125"]

Explanation

  • Determine the infusion time: The total dose is 40 mEq, and it's being infused at a rate of 10 mEq/hr.
  • Therefore, the total infusion time is 40 mEq / 10 mEq/hr = 4 hours.
  • Calculate the infusion rate in mL/hr: The total volume is 500 mL, and the infusion time is 4 hours.
  • So, the infusion rate is 500 mL / 4 hours = 125 mL/hr.

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