Question

The client is admitted complaining of nausea and vomiting for the past three days. The doctor has ordered D51/2NS with potassium added. Which action by the nurse is most appropriate? A. Obtain an IV controller B. Check the client's vital signs hourly C. Check the sodium level D. Obtain an 18-gauge cathlon to begin the infusion

Short answer

Answer: The most appropriate action for the nurse is to check the patient's sodium level. This will help prevent any complications and ensure the safety and well-being of the client before administering the D51/2NS solution with potassium.

Step-by-step solution

1. Identifying the possible actions

First, let's identify the four possible actions the nurse can take: A. Obtain an IV controller B. Check the client's vital signs hourly C. Check the sodium level D. Obtain an 18-gauge cathlon to begin the infusion

2. Analyzing the actions

Now, let us analyze each action: A. Obtain an IV controller: IV controllers are useful in maintaining the accurate flow rate of IV fluids. However, in this case, there is no specific mention of the required flow rate or the need for strict monitoring, so this option might not be the most appropriate. B. Check the client's vital signs hourly: With the patient experiencing nausea and vomiting for the past three days, monitoring their vital signs becomes essential. Ensuring the patient is stable throughout the treatment is crucial. However, there might be other options with higher priority. C. Check the sodium level: D51/2NS stands for 5% dextrose in 0.45% normal saline solution and is used for replacing fluid and electrolytes in patients. The sodium level of the patient is essential to monitor, and this solution directly affects it. Moreover, the solution also contains potassium, and it is necessary to check the patient's electrolyte levels before administering it to prevent any complications. D. Obtain an 18-gauge cathlon to begin the infusion: While this action is necessary for starting the infusion, it is not the most appropriate priority. Before administering the solution, it's essential to understand its impact on the client and ensure their safety.

3. Identifying the most appropriate action

Based on our analysis, option C (Check the sodium level) is the most appropriate action for the nurse in this situation. It is crucial to monitor the patient's electrolytes (sodium and potassium levels) before administering the D51/2NS solution to prevent any complications and ensure the safety and well-being of the client.

Key concepts

Electrolyte Monitoring

When a patient experiences symptoms such as nausea and vomiting over several days, their electrolyte balance can become disturbed. Electrolyte monitoring is a critical intervention in such scenarios, especially prior to administering intravenous (IV) therapy that includes electrolyte supplementation.

For instance, a solution like D51/2NS with added potassium will influence both sodium and potassium levels in the bloodstream. Monitoring these levels is essential because an imbalance can lead to serious complications such as cardiac arrhythmias, muscle weakness or cramps, and even neurological disorders.

To safely manage a patient's care, healthcare providers must check the relevant electrolyte levels — in this case, sodium levels. This also guides the appropriate dosing of electrolytes in IV fluids to ensure homeostasis within the body. Being informed about the patient's electrolyte status can prevent iatrogenic complications, like hyperkalemia from excess potassium or hyponatremia from sodium imbalance.

Moreover, fine-tuning the administration of fluids and electrolytes according to lab results is a cornerstone of nurturing patient recovery and stabilization.

IV Fluid Administration

Administering IV fluids is a common and critical intervention in healthcare settings. These fluids are typically used to correct imbalances in fluid volume or electrolytes, to provide medication, or to deliver nutritional supplementation intravenously. The type of IV fluid and the addition of substances like dextrose or potassium are chosen based on the patient's specific needs.

An essential part of this process is the selection of the appropriate equipment, such as an 18-gauge catheter for a robust and steady flow. However, it's just as crucial to assess the necessity and rate of the fluid administration. An IV controller can be used to ensure an accurate and controlled delivery, which can prevent potential complications from too rapid or too slow infusion rates.

Proper technique and aseptic procedures during IV fluid administration play a significant role in patient safety. This includes regular monitoring to adjust the treatment as needed and to observe for any adverse reactions or infusion-related issues such as infiltration or infection.

Patient Safety

In all healthcare procedures, patient safety is the overriding priority. It encompasses various aspects, including ensuring medication and treatment accuracy, monitoring patient vitals, and mitigating risks of treatment-related complications. Checking the patient's vital signs hourly, especially when they have been experiencing distressing symptoms, is integral to ensuring their well-being.

It's imperative for nurses to anticipate potential risks and act proactively. For example, prior to the administration of an IV solution that affects electrolyte balance, it's necessary to have a precise understanding of the patient’s current electrolyte status to avert adverse effects. Additionally, adopting an individualized approach to patient care, which considers the patient's unique health status and risks, can enhance the effectiveness of interventions and safeguard against harm.

Considering all safety measures, regular evaluation checks and assessments are foundations for a successful recovery. Each step taken by healthcare providers must be aligned with the ultimate goal: to promote the best possible outcome for the patient while preventing any preventable harm.