Which fluid order should the nurse question for a patient with a ...

[mikaylakyoung]

Which fluid order should the nurse question for a patient with a traumatic brain injury?
 
  a. 0.45 sodium chloride
  b. 0.9 sodium chloride
  c. Lactated Ringer's
  d. Dextrose 5 in 0.9 sodium chloride

Question 2

A chemotherapy patient has gained 5 pounds in 2 days. Which assessment question by the nurse is most appropriate?
 
  a. Are you having difficulty sleeping at night?
  b. How many calories a day do you con-sume?
  c. Do you have dry mouth or feel thirsty?
  d. How many times a day do you urinate?

[fur]

Answer to Question 1

ANS: A
0.45 sodium chloride is a hypotonic solution, and hypotonic solutions cause cells to swell, which can cause increased intracranial pressure. This can be life threatening for a patient with a traumatic brain injury. The other solutions are physiologically isotonic sodium-containing solu-tions that will expand ECV but will not cause cell swelling. In the fluid container, dextrose 5 in 0.9 sodium chloride is hypertonic, but the dextrose enters cells rapidly, leaving isotonic 0.9 sodium chloride.

Answer to Question 2

ANS: D
A rapid gain in weight usually indicates ECV excess if the person began with normal ECV. Ask-ing the patient about urination habits will illuminate whether the body is trying to excrete the ex-cess fluid, or if renal dysfunction is contributing to ECV excess. Difficulty sleeping at night can occur if the body builds up excessive fluid in the lungs; however, it could also mean that the pa-tient is getting up frequently to urinate, so the question is not specific enough. Caloric intake does not account for rapid weight changes. Dry mouth and thirst accompany ECV deficit, which would be associated with rapid weight loss.

[mikaylakyoung]

Gracias!

[frankwu0507]

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