Test Questions

In what format is this question written as? Multiple choice or do you need to write out the answer? Either way, it seems like the stem of the question is asking what effects would the solution have on the body.

It's multiple choice, but thanks for your input

A 5year old male presents to ER with delirium and sunken eyes. After diagnosing him with severe dehydration the physician orders fluid replacement. The nurse administers a HYPERTONIC IV SOLUTION. Which of the following would be expected ? Does anyone have a clue what the answer could be i have been trying to figure it out. At first i put hypertonic solutions such as D5w in .9NS , 10% Dextrose. But i really dont believe thats what the question is asking for. Can someone please give me some insight as to what they believe the question is asking. It will be greatly appreciated thanks.

Standard procedure is to assume isonatremic dehydration. You would give NS (0.9%). Unless you absolutely know he's got very low sodium levels, you shouldn't be giving a hypertonic solution.

D5W in .9% NS is isotonic but with dextrose. It is NOT a hypertonic solution.

If you give him a hypertonic IV solution (like 1.5 NS) (hypertonic = more salt). You are giving him excess sodium which would lead to hypernutremia Doing so could lead to brain damage, edema, and death.

This is from my notes on electrolyte balance.

Thanks for your input very helpful

First you have to know the types of fluid: isotonic,hypotonic, and hypertonic. Then apply to principle of diffusion. If you have a hypertonic solution you have more solute then in the blood (isotonic) and you would expect fluid to be taken away from cells. Without knowing the choices to your question, I would immediately stop the infusion because someone that severely dehydrated and suffering from delirium. They most likely already have a high sodium and a hypertonic solution would only increase the Na level,The initial treatment for the severe dehydration would be an isotonic solution like normal saline and then eventually over to a hypotonic solution. I'm curious to know what your choices are.

I will be sure to let you the choices after take my test on Monday!!!!!!!! Thanks that makes since when you broke it down :-)

hypertonic fluids pulls water from cells and interstitial spaces into the blood vessels. SO, the blood pressure will increase. However, cellular hydration will not be corrected. Would have to see the question but I think the jist is they want you to know the action of the fluid and is it what the patient needs.