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Promoting Fluid and Electrolyte Balance
Promoting Fluid and Electrolyte Balance ( 5 Questions)
A nurse is caring for a client who has dehydration and is receiving dextrose 5% in water (D5W) intravenously. The nurse should monitor the client for which of the following complications of this type of solution?
Hyperglycemia. This is incorrect because dextrose 5% in water (D5W) is not likely to cause hyperglycemia in a dehydrated client. D5W is a hypotonic solution that provides free water and glucose to the body. The glucose is rapidly metabolized by the cells, leaving only water in the intravascular space. This water then moves into the intracellular and interstitial compartments, rehydrating the tissues. Therefore, D5W does not increase the blood glucose level significantly in a dehydrated client.
Hyperkalemia. This is incorrect because dextrose 5% in water (D5W) does not contain any potassium or other electrolytes. Hyperkalemia is a condition of high potassium level in the blood, which can be caused by renal failure, acidosis, tissue injury, or excessive intake of potassium-rich foods or supplements. D5W does not affect the potassium level in the blood.
Fluid overload. This is correct because dextrose 5% in water (D5W) can cause fluid overload in a client who has impaired fluid regulation mechanisms, such as heart failure, kidney disease, or liver disease. Fluid overload is a condition of excess fluid volume in the body, which can lead to edema, hypertension, dyspnea, crackles, jugular venous distension, and pulmonary congestion. D5W can cause fluid overload by expanding the intravascular volume and shifting water into the interstitial and intracellular spaces.
Metabolic acidosis. This is incorrect because dextrose 5% in water (D5W) does not cause metabolic acidosis in a dehydrated client. Metabolic acidosis is a condition of low pH and low bicarbonate level in the blood, which can be caused by diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, or ingestion of toxic substances. D5W does not affect the pH or bicarbonate level in the blood.
Choice A reason: Hyperglycemia. This is incorrect because dextrose 5% in water (D5W) is not likely to cause hyperglycemia in a dehydrated client. D5W is a hypotonic solution that provides free water and glucose to the body. The glucose is rapidly metabolized by the cells, leaving only water in the intravascular space. This water then moves into the intracellular and interstitial compartments, rehydrating the tissues. Therefore, D5W does not increase the blood glucose level significantly in a dehydrated client.
Choice B reason:
Hyperkalemia. This is incorrect because dextrose 5% in water (D5W) does not contain any potassium or other electrolytes. Hyperkalemia is a condition of high potassium level in the blood, which can be caused by renal failure, acidosis, tissue injury, or excessive intake of potassium-rich foods or supplements. D5W does not affect the potassium level in the blood.
Choice C reason:
Fluid overload. This is correct because dextrose 5% in water (D5W) can cause fluid overload in a client who has impaired fluid regulation mechanisms, such as heart failure, kidney disease, or liver disease. Fluid overload is a condition of excess fluid volume in the body, which can lead to edema, hypertension, dyspnea, crackles, jugular venous distension, and pulmonary congestion. D5W can cause fluid overload by expanding the intravascular volume and shifting water into the interstitial and intracellular spaces.
Choice D reason:
Metabolic acidosis. This is incorrect because dextrose 5% in water (D5W) does not cause metabolic acidosis in a dehydrated client. Metabolic acidosis is a condition of low pH and low bicarbonate level in the blood, which can be caused by diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, or ingestion of toxic substances. D5W does not affect the pH or bicarbonate level in the blood.