A patient diagnosed with hypovolemic shock is prescribed intravenous fluids while awaiting blood transfusions. Which solution does the nurse recognize would be best for this patient?
1. Ringer's lactate
2. Dextrose 5% and water
3. Dextrose 5% and 0.45% normal saline
4. Dextrose 5% and 0.9% normal saline
Correct Answer: 1
Ringer's lactate and 0.9% saline are the fluids of choice in treating hypovolemic shock, especially in the emergency phase of care while blood is being typed and crossmatched. Large amounts of these solutions may be infused rapidly, increasing blood volume and tissue perfusion. Hypotonic crystalloid solutions, such as dextrose 5% in water or normal saline, increase fluid volume in both the intravascular and interstitial spaces. But approximately 25% of the fluid stays within the intravascular space, increasing the risk of peripheral edema.
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