The health care provider prescribes intravenous fluid resuscitation for a client in hypovolemic shock. The nurse should anticipate the rapid infusion of which intravenous solution initially? A)0)9% Sodium chloride B)5% Albumin C)Dextrose 5% and lactated Ringer's D)Dextrose 5% and water

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11ecbb05_cb31_5051_b433_4b2886420f7f_MD0009_00 Normal saline is the fluid of choice for rapid correction of hypotension in most situations, including hypovolemic and septic shock. It can be administered in large quantities rather rapidly and is inexpensive. (Option B) When 5% albumin, a colloid solution, is infused into the intravascular space, it mobilizes fluid from the extravascular tissues into the extracellular vascular space. Although it is equally effective in expanding intravascular fluid volume, it is expensive and not the initial fluid of choice. It can be used in clients with low intravascular protein (albumin) content and hypotension but increased fluid in extravascular tissues (eg, cirrhosis with ascites). (Option C) When dextrose 5% and lactated Ringer's, a hypertonic solution, is infused into the intravascular space, it mobilizes fluid from the extravascular tissue into the extracellular vascular space. Although it may be used to expand fluid volume, it is not the initial intravenous fluid of choice. (Option D) When the dextrose in dextrose 5% and water is metabolized, a hypotonic solution is left. In large volumes, it can cause shift of the fluid into the extravascular compartment, which may cause further hypotension in clients with low blood pressure. Hypotonic solutions (0.45% saline or dextrose 5% and water) are typically used to treat hypernatremia. Educational objective: Isotonic solutions are used for immediate fluid resuscitation in clients with hypovolemic shock.

The Health Care Provider Prescribes Intravenous Fluid Resuscitation for a Client