The nurse is caring for a client with a medical diagnosis of increased intracranial pressure. Which IV fluid order would the nurse accept without questioning?
1. Run normal saline at 125 mL/hour.
2. Run 5% dextrose in water at 80 mL/hour.
3. Run 5% dextrose in 0.45% NaCl at 75 mL/hour.
4. Run half-normal saline at 200 mL/hour.
Correct Answer: 3
Isotonic and hypotonic fluids should not be administered to clients with increased intracranial pressure, because they increase the risk of cerebral edema. D5 in one-half normal saline is hypertonic, and would be an acceptable IV solution for this client. Normal saline and D5W are isotonic solutions, and so would need to be questioned. Half-normal saline is hypotonic, and so would not be advisable for this client.
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