Med Surge Ch. 10 - Fluid & Electrolytes NCLEX Exam with 100% Correct Answers

Med Surge Ch. 10 - Fluid & Electrolytes NCLEX Exam with 100% Correct Answers A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering? 1. 3% sodium chloride 2. 10% dextrose in water 3. 0.45% sodium chloride 4. lactated Ringer's solution *Ans* 4. Ringer's solution is an isotonic, balanced electrolyte solution that can expand plasma volume and help restore electrolyte balance. 3% NaCl - hypertonic 0.45% NaCl - maintenance soln 10% dextrose - hypertonic Which manifestation should the nurse expect to assess in a patient with fluid volume deficit? 1. Headache and muscle cramps 2. Dyspnea and respiratory crackles 3. Increased pulse rate and blood pressure 4. Orthostatic hypotension and flat neck veins *Ans* 4. In fluid volume deficit, there is less volume in the vascular system, which decreases venous return and cardiac output, leading to manifestations of dizziness, orthostatic hypotension, and flat neck veins. The nurse is planning care for a patient with acute hypernatremia. What should the nurse include in this patient's plan of care? (Select all that apply) 1. Maintain IV access 2. Limit length of visits 3. Restrict fluids to 1500 mL per day 4. Conduct frequent neurologic checks 5. Orient to time, place, and person every 2 hours. *Ans* 1, 4, 5 Frequent neurologic checks are necessary as hypernatremia draws water out of brain cells, causing them to shrink. As the brain shrinks, tension is placed on cerebral vessels, which may cause them to tear and bleed. Hypernatremia affects mental status and brain function including orientation to time, place, and person. Fluid replac