The nurse is caring for a patient in DKA with serum sodium of 130 and serum glucose of 600. After calculating the corrected serum sodium (CSS) [CSS = Serum Na+ + {[(Serum glucose (mg/dL) - 100)/100] × 1
6}], which intravenous fluid would the nurse plan to provide this patient? 1. D5 ½ NS
2. 0.45 NS
3. 0.9 NS
4. Lactated Ringer's (LR)
2
Rationale 1: CSS = 130 + {[(600 - 100)/100] × 1.6}; CSS = 138. Normal serum sodium is
135 ? 145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
Rationale 2: CSS = 130 + {[(600 - 100)/100] × 1.6}; CSS = 138. Normal serum sodium is
135 ? 145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
Rationale 3: CSS = 130 + {[(600 - 100)/100] × 1.6}; CSS = 138. Normal serum sodium is
135 ? 145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
Rationale 4: CSS = 130 + {[(600 - 100)/100] × 1.6}; CSS = 138. Normal serum sodium is
135 ? 145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
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