Author Question: The nurse is caring for a patient with an altered level of consciousness (LOC). Which intravenous ... (Read 74 times)

renzo156 · **on:** Jun 25, 2018

The nurse is caring for a patient with an altered level of consciousness (LOC). Which intravenous fluid should the nurse expect to be prescribed for this patient?

1. isotonic or hypertonic
2. 0.45 normal saline
3. dextrose 5 in water
4. dextrose 5 in 0.45 normal saline

Question 2

Reviewing the patient's report of laboratory test results as provided, the nurse realizes that which results are critical for the patient with a decreased level of consciousness?

1. glucose and serum osmolality
2. sodium and potassium levels
3. sodium and white blood cell count
4. glucose and white blood cell count

Anton · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1
Isotonic (0.9 normal saline) or slightly hypertonic (lactated Ringer's) IV solutions are used in the patient with LOC. Hypotonic solutions (such as 0.45 saline, D5W and D5W in 0.45 normal saline) will cause fluid to move into the cells and worsen cerebral edema. Highly hypertonic solutions will cause fluid to move out of the cells.

Answer to Question 2

Correct Answer: 1
Blood glucose is measured immediately when coma or decreased LOC is of unknown origin. When the glucose falls to less than 50 mg/dL, cerebral function declines rapidly and hypoglycemia should be suspected. Serum osmolality of less than 250 mOsm/kg H2O leads to cerebral edema and swelling, impairing consciousness. The other lab values are normal.