The nurse plans to administer fluid to a client with SIRS and hypotension. Which of the following orders should the nurse anticipate to prevent progression of shock?
1. Administer 1000 ml of lactated ringers over the next 2 hours.
2. Infuse 20 ml of D5½ normal saline solution per hour.
3. Give 3% saline at a rate of 20 ml/hour.
4. Administer D5W at a rate of 100 ml/hour.
Administer 1000 ml of lactated ringers over the next 2 hours.
Rationale: Isotonic solutions, such as normal saline or lactated ringers, should be administered at a rate of 20 ml/kg/hr and increased to maintain urine output of 0.5 ml/kg/hr. D5½ normal saline is a slightly hypertonic fluid; the rate of infusion is too low for patients in shock. Three percent saline is hypertonic. D5W is a hypotonic solution.
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