PSA Fluid and Electrolyte Prescribing Flashcards

A patient is admitted with hypovolemic shock following gastrointestinal bleeding. Which intravenous fluid is most appropriate for initial resuscitation?

Answer: 0.9% Normal saline (isotonic saline)

Isotonic saline (0.9% NaCl) is the standard initial fluid for hypovolemic shock because it expands intravascular volume effectively.

Which of the following is the most appropriate fluid for replacing isolated free water deficit in a patient with hypernatremia?

Answer: 5% Dextrose in water (D5W)

D5W is effectively free water after glucose is metabolized and is the preferred fluid for correcting hypernatremia due to free water deficit.

A post-operative patient develops oliguria. What is the first step in assessing fluid status before prescribing additional IV fluids?

Answer: Assess clinical signs of hypovolemia and review fluid balance

Clinical assessment of volume status (skin turgor, BP, HR, fluid balance) is essential before prescribing additional fluids to avoid fluid overload.

What complication can result from rapid correction of chronic hyponatremia?

Answer: Osmotic demyelination syndrome

Correcting chronic hyponatremia too rapidly risks osmotic demyelination syndrome (previously called central pontine myelinolysis).

Which IV fluid is most appropriate for a patient with diabetic ketoacidosis (DKA) after initial stabilization?

Answer: 0.9% Normal saline followed by 0.45% saline with dextrose when glucose falls

In DKA, isotonic saline is used initially; as serum glucose approaches 200 mg/dL, dextrose-containing fluid is added to prevent hypoglycemia while continuing insulin.

A patient is receiving large volumes of 0.9% normal saline for resuscitation. Which electrolyte abnormality is most likely to develop?

Answer: Hyperchloremic metabolic acidosis

Large volumes of normal saline contain high chloride (154 mEq/L), which can cause hyperchloremic (non-anion gap) metabolic acidosis.