A patient with hyperglycemic hyperosmolar syndrome (HHS) has a serum glucose level of 400 mg/dL and a serum sodium level of 138 mEq/L. The intravenous fluid of choice would be
a. D5W. c. 0.9% NS.
b. 0.45% NS. d. D5/NS.
C
The fluid deficit may be as much as 150 mL/kg of body weight. The average 150-lb adult can lose more than 7 to 10 L of fluid. Physiologic saline solution (0.9%) is infused at 1 L/hr, especially for patients in hypovolemic shock if there is no cardiovascular contraindication. Several liters of volume replacement may be required to achieve a blood pressure and central venous pressure within normal range. Infusion volumes are adjusted according to the patient's hydration state and sodium level.
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