Author Question: The physician orders a hypertonic crystalloid solution for the patient in critical care who has ... (Read 81 times)

anjilletteb · **on:** Jul 23, 2018

The physician orders a hypertonic crystalloid solution for the patient in critical care who has cerebral edema. The nurse hangs a bag of a hypotonic solution. What will the priority assessment by the nurse include?

1. Headache, irritability, and decreasing level of consciousness
2. Nausea, projectile vomiting, and pinpoint pupils
3. Confusion, hallucinations, and agitation
4. Hypertension, headache, and nausea

Question 2

The patient has been running in a long-distance marathon on a very warm day. The patient complains of dizziness and nausea, and is taken to the hospital where she becomes lethargic. The serum sodium level is 125 mEq/L.

What will be the best plan of the nurse?
1. Prepare to encourage the patient to drink fluids.
2. Prepare to administer normal saline intravenous (IV).
3. Prepare to administer 0.45 NaCl.
4. Prepare to provide a diet high in NaCl.

mceravolo · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale: A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. Headache, irritability, and decreasing level of consciousness are signs of cerebral edema. Confusion, hallucinations, and agitation are not classical signs of cerebral edema. Hypertension and nausea are not classical signs of cerebral edema. Projectile vomiting and pinpoint pupils are not classical signs of cerebral edema.

Answer to Question 2

Correct Answer: 2
Rationale: Hyponatremia is a serum sodium level less the 135 mEq/L. Hyponatremia caused by sodium loss may be treated with intravenous (IV) fluids containing salt, such as normal saline. 0.45 NaCl is a hypotonic solution and will further lower the serum sodium. The patient requires intravenous (IV) fluids at this point, not oral fluids. The patient requires intravenous (IV) fluids at this point, not foods high in NaCl.