While admitting a new patient to your medical-surgical unit, you note that the patient is oliguric
You notify the the acute-care nurse practitioner who orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. What do you know this intervention will do?
A) Help distinguish hyponatremia from hypernatremia
B) Help evaluate pituitary gland function
C) Help distinguish reduced renal blood flow from decreased renal function
D) Help provide an effective treatment for hypertension-induced oliguria
Ans: C
Feedback: If a patient is not excreting enough urine, the health care providers needs to determine whether the depressed renal function is the result of reduced renal blood flow, which is a fluid volume deficit (FVD or prerenal azotemia), or acute tubular necrosis that results in necrosis or cellular death from prolonged FVD. A typical example of a fluid challenge involves administering 100 to 200 mL of normal saline solution over 15 minutes. The response by a patient with FVD but normal renal function is increased urine output and increase in blood pressure. Option A is incorrect; laboratory exams are needed to distinguish hyponatremia from hypernatremia. Option B is incorrect; a fluid challenge is not used to evaluate pituitary gland function. Option D is incorrect; a fluid challenge may give you information regarding hypertension-induced oliguria, but it is not an effective treatment.
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