The nurse is caring for a patient with an altered level of consciousness (LOC). Which intravenous fluid should the nurse expect to be prescribed for this patient?
1. isotonic or hypertonic
2. 0.45% normal saline
3. dextrose 5% in water
4. dextrose 5% in 0.45 % normal saline
Correct Answer: 1
Isotonic (0.9% normal saline) or slightly hypertonic (lactated Ringer's) IV solutions are used in the patient with LOC. Hypotonic solutions (such as 0.45% saline, D5W and D5W in 0.45% normal saline) will cause fluid to move into the cells and worsen cerebral edema. Highly hypertonic solutions will cause fluid to move out of the cells.
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