The nurse is caring for a patient with severe sepsis who was resuscitated with 3000 mL of lactated Ringer solution over the past 4 hours.Morning laboratory results show a hemoglobin of 8 g/dL and hematocrit of 28%.What is the best interpretation of these findings by the nurse?
A) Blood transfusion with packed red blood cells is required.
B) Hemoglobin and hematocrit results indicate hemodilution.
C) Fluid resuscitation has resulted in fluid volume overload.
D) Fluid resuscitation has resulted in third spacing of fluid.

Question

Quizplus · Accepted Answer

Fluid resuscitation with large volumes of crystalloid results in hemodilution of red blood cells and plasma proteins.Hemoglobin and hematocrit results indicate hemodilution.Given the clinical scenario,there is no evidence to support the need for a blood transfusion and no evidence of fluid overload.Although administration of large volumes of crystalloid can result in hemodilution of plasma proteins leading to third spacing of fluid,this fact does not support the hemoglobin and hematocrit results.

The Nurse Is Caring for a Patient with Severe Sepsis