Promoting Fluid and Electrolyte Balance
Promoting Fluid and Electrolyte Balance ( 5 Questions)
A client who has Addison's crisis is receiving dextrose 5% in normal saline intravenously. The client asks the nurse why this type of solution is used. Which of the following responses should the nurse give?
This is incorrect because dextrose 5% in normal saline is a hypertonic solution that will increase the blood sugar level, not lower it. Patients with Addison's crisis have low cortisol levels, which can impair glucose metabolism and cause hypoglycemia, so they need glucose supplementation.
This is partially correct because dextrose 5% in normal saline will provide some nutrition with glucose, but this is not the main reason for using this solution in Addison's crisis. Patients with Addison's crisis have low aldosterone levels, which can cause hyponatremia and hypovolemia, so they need sodium and fluid replacement.
This is correct because dextrose 5% in normal saline will correct the low sodium level caused by aldosterone deficiency in Addison's crisis. Sodium is essential for maintaining blood pressure, fluid balance, and nerve and muscle function. Dextrose 5% in normal saline will also increase the blood volume and prevent dehydration and shock.
This is partially correct because dextrose 5% in normal saline will increase the blood volume, but this is not the only solution that can do that. Other isotonic or hypertonic solutions can also expand the intravascular space. Dextrose 5% in normal saline is preferred in Addison's crisis because it also provides glucose and sodium, which are both deficient in this condition.
Choice A reason:
This is incorrect because dextrose 5% in normal saline is a hypertonic solution that will increase the blood sugar level, not lower it. Patients with Addison's crisis have low cortisol levels, which can impair glucose metabolism and cause hypoglycemia, so they need glucose supplementation.
Choice B reason:
This is partially correct because dextrose 5% in normal saline will provide some nutrition with glucose, but this is not the main reason for using this solution in Addison's crisis. Patients with Addison's crisis have low aldosterone levels, which can cause hyponatremia and hypovolemia, so they need sodium and fluid replacement.
Choice C reason:
This is correct because dextrose 5% in normal saline will correct the low sodium level caused by aldosterone deficiency in Addison's crisis. Sodium is essential for maintaining blood pressure, fluid balance, and nerve and muscle function. Dextrose 5% in normal saline will also increase the blood volume and prevent dehydration and shock.
Choice D reason:
This is partially correct because dextrose 5% in normal saline will increase the blood volume, but this is not the only solution that can do that. Other isotonic or hypertonic solutions can also expand the intravascular space. Dextrose 5% in normal saline is preferred in Addison's crisis because it also provides glucose and sodium, which are both deficient in this condition.