Final Answer:
The nurse anticipates a prescription for fluid replacement with 0.45% saline.Thus the correct answer is B.
Step-by-step explanation:
The patient's symptoms—nausea, vomiting, hypotension (blood pressure 80/44 mm Hg), tachycardia (heart rate 122 beats/min), and lack of urination for 8 hours—indicate hypovolemia or low blood volume. The immediate need is to restore intravascular volume to stabilize the patient's blood pressure and heart rate. Calculating the patient's Mean Arterial Pressure (MAP) is essential to determine the severity of hypotension. MAP = Diastolic BP + 1/3 (Systolic BP - Diastolic BP). For this patient: MAP = 44 + 1/3(80 - 44) = 44 + 12 = 56 mm Hg, which is critically low.
Given the patient's condition and MAP, the priority is fluid resuscitation. 0.45% saline (hypotonic solution) provides free water and sodium to expand intravascular volume more effectively than isotonic solutions due to osmotic shifts. The goal is to raise the MAP to improve tissue perfusion and stabilize vital signs. Other options, such as blood transfusion or inotropic agents, might be necessary later depending on specific diagnoses, but immediate fluid replacement is crucial to address hypovolemia and prevent further complications.
Administering an antiemetic might alleviate the symptoms but won't address the underlying issue of hypovolemia, and in this critical scenario, stabilizing the patient's hemodynamics takes precedence. Therefore, based on the patient's presentation and critical low MAP, fluid replacement with 0.45% saline is the immediate priority to correct hypovolemia and stabilize the patient's condition.