Question

A patient had a craniotomy 2 days ago for removal of a tumor. He is awake and talking to the nurse and demonstrates no neurologic deficit. Blood pressure is 110/80 mm Hg, pulse is 92 beats/min, and respiratory rate is 22 breaths/min. Urine outputs have been approximately 60 ml/hr over the last 2 days, but he has had a recent change. He has had 300 to 400 ml/hr of urine output over the last several hours. The urine has a specific gravity of 1.002. The nurse checks his serum glucose and finds that it is 100 mg/dl. The intravenous solution most appropriate for fluid replacement would be:

A. 5% dextrose in water (D5W).
B. normal saline.
C. lactated Ringer solution.
D. 10% dextrose in water (D10W).

Answer 1

The most suitable intravenous solution for a patient with increased urine output and a normal blood glucose level following a craniotomy is normal saline, as it helps maintain fluid and electrolyte balance.

Step-by-step explanation:

A patient who had a craniotomy and is now experiencing a significant increase in urine output to 300 to 400 ml/hr with a low specific gravity of 1.002 may be showing signs of diabetes insipidus, which is characterized by the excretion of large amounts of dilute urine. Since the serum glucose level is normal, diabetes mellitus is ruled out. The best intravenous solution for fluid replacement in this scenario would be normal saline, an isotonic solution, which will help to restore proper fluid and electrolyte balance without causing additional blood glucose changes.