Let's review this question together. Remember reading this on the practice questions?
There's a lot of information here.
Let me encourage you as you're going through this question, make sure you break it down.
Who are you in this question? You are a nurse. What was particular about this client?
Well, they're in an ER, they had abdominal trauma after a motor vehicle accident.
Well, those are diagnosis. You're thinking abdominal trauma, what am I worried about?
Well, you fast forward, what's the biggest problem?
Yeah, hemorrhage. That's what I'm worried about after abdominal trauma.
So the client's vital signs are heart rate: high, low, or normal?
That's high. Is there any relation to hemorrhage with a high heart rate?
Yes. Blood pressure. High, low, or normal? Low. High heart rate, low blood pressure.
Not a good sign. That's a sign of volume loss. Respiration's 24.
Not that worried about that. Temperature 98.9. Again, not my top concern.
But that last question, which of the following orders would be most important for the nurse to question?
Well, it's something that's wrong or unsafe.
I know I have somebody who's had an abdominal trauma.
I'm worried about hemorrhage before I even see their vital signs.
When I look at their vital signs, their blood pressure's too low, heart rate is too high,
which is a clear sign of hypovolemic shock, right?
That's where we're headed so I don't wanna give any solution that's going to make this worse.
So as you look through, I have 4 solutions to choose from?
So I'm gonna be thinking are they isotonic, hypotonic, or hypertonic?
So take a minute and write yourself a note.
Answer that question as a way to review what we just discussed.
Okay, so I want you to pack red blood cells.
Doesn't seem like a bad idea. In fact, it isn't, right?
Because the question is asking which of the following orders would it be most important for you to question?
One unit packed red blood cells would be safe so I'm not gonna question that one.
As you look through the 3 remaining orders,
which one of these would be most dangerous to your patient?
Correct, it's the hypotonic solution because that's gonna cause the blood pressure to drop even farther.
If I hang a hypotonic solution like half normal saline,
what's gonna happen is fluid is gonna go into the cells, out of the intravascular space,
which will lower the patient's blood pressure.
Okay, can you see now how wow, we spent a lot of time on IV fluids.
Yes, because I wanted to give you a feel for how these types of questions can come at you.
So now I know what to know, how to prepare for it,
and how you can take the information that you've learn about IV fluids
and apply it to exam questions.
Okay, now here's your chance to review. You did a good job with that question.
Now, I want you to supercharge your memory.
It's your opportunity to study as you go.
Without looking at your notes, what are the 3 types of IV solutions?
Now, I want you to try and name 2 IV fluids that cause fluid volume
to shift from the cells into the intravascular space.
This one makes it a little harder.
I want you to name 2 IV solutions, make sure they're from different categories.
Now, think about the types of patients that you should use it for, that's the check mark,
and patients that you should not. That's the X.
So pause the video, take your time, come up from -- with IV solutions from 2 different types,
while list the patients you should give them to and the ones you should not.