Which of the following statements regarding hypertonic (3%) sodium chloride is correct?
Hypertonic fluids are contraindicated in patients with cerebral edema.
Hypertonic saline may be administered to shift fluid out of brain tissue.
Hypertonic saline is most often used for clients in hypernatremia.
Hypertonic fluids are administered to promote increased brain tissue hydration.
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
Explanation
A. Administering a hypotonic solution would not be appropriate in this case. Hypotonic solutions can lower the blood pressure further and worsen the patient’s condition.
B. Administering a vasoconstrictor medication may increase blood pressure, but it is not the first-line treatment for dehydration or volume loss, which seems to be the cause of the patient’s symptoms.
C. Administering an isotonic solution intravenously is the most appropriate intervention. The patient is likely experiencing dehydration and hypotension due to fluid loss from exertion in the sun (possibly heat exhaustion). Isotonic fluids such as normal saline or lactated Ringer's solution are typically used to restore circulating volume and improve blood pressure.
D. Administering a hypertonic solution would be inappropriate, as it could increase the osmolarity of the blood and worsen dehydration, potentially causing fluid shifts that could lead to complications such as cellular dehydration.
Correct Answer is B
Explanation
A. Administering oxygen is important, but the priority is reversing the opioid-induced respiratory depression with naloxone. Oxygen alone will not address the underlying cause of the decreased level of consciousness.
B. Administering naloxone (Narcan) is the priority intervention because it is an opioid antagonist that will reverse the effects of morphine and other opioids, improving respiratory function and consciousness.
C. Opening the airway is important, but the primary issue here is opioid overdose, which requires naloxone administration for reversal of respiratory depression.
D. Placing the patient in the shock position is not indicated in this scenario. The focus should be on reversing opioid toxicity, not on positioning for shock.
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