Question

The client is admitted with isotonic dehydration. The nurse would anticipate an order for which IV fluid? A. \(5 \%\) dextrose and water B. \(3 \%\) sodium chloride C. \(.9 \%\) sodium chloride D. \(.45 \%\) sodium chloride

Short answer

Answer: The best IV fluid for treating a patient with isotonic dehydration is 0.9% sodium chloride.

Step-by-step solution

Analyze each IV fluid option

We need to check each option and see if it will help replenish the water and sodium lost without disrupting the balance. A. \(5\%\) dextrose and water: This fluid consists of sugar (dextrose) and water, which helps increase blood sugar levels, but does not help in replenishing sodium. B. \(3\%\) sodium chloride: This fluid is highly concentrated and hypertonic, meaning that it has a higher concentration of sodium than the body fluids. This could create an imbalance and may not be suitable for isotonic dehydration. C. \(.9\%\) sodium chloride: This fluid is isotonic, with a concentration of about 154 mEq/L, which mimics the body's normal extracellular fluid (ECF) concentration. This fluid would be effective in maintaining the sodium and water balance in the body. D. \(.45\%\) sodium chloride: This fluid is hypotonic, which means it has a low sodium concentration and can lead to dilution of the serum sodium levels in the body, creating an imbalance.

Select the best IV fluid

Based on the analysis, the best IV fluid for the treatment of isotonic dehydration is option C: \(.9\%\) sodium chloride. This fluid has the appropriate sodium and water composition to maintain the balance in the patient's body, and as a result, help to treat the condition effectively.

Key concepts

Isotonic Dehydration

When it comes to isotonic dehydration, understanding the balance between electrolytes and fluids in the body is key. In isotonic dehydration, both salt and water are lost in equal proportions. This maintains the balance of the fluids outside the cells, called extracellular fluid (ECF). However, it can still lead to reduced blood volume and affect organ functions if not addressed. It is important to recognize that isotonic dehydration does not cause the cells to shrink or swell since the fluid and electrolyte balance remains equal in terms of concentration. Identifying common causes such as vomiting, diarrhea, or excessive sweating can help address it promptly.
The treatment involves replacing the lost fluids and salts with the appropriate solutions, ensuring the body’s needs are met efficiently.

IV Fluids

Intravenous fluids, or IV fluids, are crucial in treating dehydration and restoring fluid and electrolyte balance. Administered directly into the bloodstream, these fluids work rapidly to correct imbalances.
There are different types of IV fluids, namely:

• Isotonic solutions - where the fluid concentration is similar to the body's ECF, such as .9% sodium chloride.
• Hypotonic solutions - with lower concentration than body fluids, like .45% sodium chloride, which can cause cells to swell.
• Hypertonic solutions - with higher concentration, such as 3% sodium chloride, which can draw water from the cells.

IV fluids are selected based on the specific needs of the patient and the type of dehydration or imbalance present.

Nursing Care

Nursing care for a patient with dehydration focuses on monitoring and maintaining fluid and electrolyte balance. Nurses need to regularly assess vital signs and membrane turgor, which reveal much about the patient's hydration status.
They must also watch for:

• Signs of fluid overload, such as swelling or shortness of breath.
• Ensure accurate input and output monitoring to track the fluid balance.
• Encourage oral fluid intake if appropriate and adjust the IV fluid administration accordingly.

A nurse's timely intervention and accurate monitoring can make a significant difference in the patient's recovery from dehydration.

Sodium Chloride

Sodium chloride, essentially table salt, plays significant roles in the body. It’s essential for maintaining fluid balance, nerve function, and muscle contractions. Its presence in various IV fluids makes it a versatile tool in medical settings.
An understanding of sodium chloride concentrations helps determine how it interacts with body fluids:

• .9% sodium chloride: This isotonic solution mimics the body's normal ECF and helps restore fluid balance without disrupting cellular stability.
• .45% sodium chloride: A hypotonic solution that could risk lowering extracellular sodium, affecting water movement in cells.
• 3% sodium chloride: Hypertonic and higher in sodium concentration, useful in specific medical situations but not for isotonic dehydration.

Using sodium chloride wisely under medical supervision aids in effectively treating various dehydration types and maintaining the body’s homeostasis.