Question

A patient with severe trauma is admitted to the intensive care unit. The patient has received 5000 mL of normal saline, is exhibiting peripheral edema, and remains hypotensive. The nurse anticipates administering which substance to correct fluid balance?

a. Ringer's lactate
b. 3% saline solution
c. hetastarch (Hespan)
d. D5W

Answer 1

The nurse anticipates administering hetastarch (Hespan) to help increase the plasma volume which can subsequently correct the patient's fluid imbalance and manage hypotension.

Step-by-step explanation:

The patient in the ICU with severe trauma, peripheral edema, and persistent hypotension after receiving 5000 mL of normal saline requires a substance that can help correct fluid balance. Given that the standard treatment of dehydration involves the administration of isotonic saline or a combination of isotonic saline and sodium lactate intravenously, and considering the patient's condition, the nurse would anticipate administering hetastarch (Hespan). Hetastarch is a colloid used to expand plasma volume, thus helping to increase blood pressure. It is chosen because other options like D5W (dextrose in water) are hypotonic and Ringer's lactate is similar to normal saline, which has already been given in large volume. 3% saline is hypertonic and might not be preferred due to the patient's edema. Therefore, a colloid like hetastarch could be more appropriate to manage the patient's hypotension without exacerbating the peripheral edema.