The nurse cares for a patient in the critical care setting who ...

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The nurse cares for a patient in the critical care setting who was severely burned. The wife of the patient asks the nurse, Why does he need those intravenous infusions (IVs)?
 
  What is (are) the best response(s) by the nurse that indicates the primary reason for intravenous infusions (IVs) with a burned patient?
  1. So we have an open line for resuscitation in case his heart stops.
  2. So he can receive his antibiotics.
  3. So we can keep his blood pressure stable.
  4. So we can be sure he keeps enough blood volume.
  5. So we can rapidly administer his pain medications.

Question 2

The patient is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. What is the nurse's priority action?
 
  1. Increase the rate of the infusion and continue to assess the patient for symptoms of acidosis.
  2. Decrease the rate of the infusion and continue to assess the patient for symptoms of alkalosis.
  3. Continue the infusion; the patient is still in acidosis.
  4. Stop the infusion and notify the physician; the patient is in alkalosis.

[katara]

Answer to Question 1

Correct Answer: 3,4
Rationale: Net loss of fluids from the body can result in dehydration and shock. Intravenous (IV) fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (IV) fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (IV) fluid replacement. Administration of analgesics is not a primary reason for intravenous (IV) fluid replacement.

Answer to Question 2

Correct Answer: 4
Rationale: The patient receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The patient's symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis, symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis.

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TYSM

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Gracias!