Question

A 17-year-old sustained a head injury in a motorcycle collision two days ago and is responsive only to pain. Which IV solution order would the nurse question because it would increase the risk of complications?

Question 10 options:
Ringer's solution
0.9% NaCl
Lactated Ringer's solution
Dextrose 5% in Water (D5W)

Answer 1

The IV solution that a nurse should question for a patient with a head injury is Dextrose 5% in Water (D5W) because it is a hypotonic solution and may exacerbate cerebral edema. Isotonic solutions like Ringer's solution, 0.9% NaCl, and Lactated Ringer's solution are better alternatives as they maintain hemodynamic stability.

Step-by-step explanation:

Questioning the IV Solution

Regarding the treatment of a patient with a head injury, the IV solution that should be questioned by the nurse is Dextrose 5% in Water (D5W). D5W is a hypotonic solution, which means it has a lower concentration of solutes compared to the blood. Administering a hypotonic solution to a patient with a brain injury can be particularly dangerous as it may exacerbate cerebral edema (swelling of the brain), thus increasing the risk of complications. In contrast, isotonic solutions such as Ringer's solution, 0.9% NaCl, and Lactated Ringer's solution have the same osmotic pressure as body fluids and are generally safer in this scenario.

Isotonic solutions are important because they do not cause a significant shift in fluid between the extracellular and intracellular compartments, therefore maintaining hemodynamic stability. They can effectively correct dehydration without causing detrimental shifts in fluid balance that could negatively affect the patient's intracranial pressure.

Answer 2

The nurse should question an order for Dextrose 5% in Water (D5W) for a head injury patient because it can lead to cerebral edema after metabolism.

Step-by-step explanation:

A 17-year-old who sustained a head injury and is responsive only to pain requires careful selection of intravenous (IV) solutions to avoid increasing the risk of complications. The most appropriate IV solutions for such a patient would be isotonic solutions like normal saline (0.9% NaCl) or Lactated Ringer's solution, which are in balance with the body's electrolytes and do not cause fluid shifts that could exacerbate brain swelling.

Dextrose 5% in Water (D5W), on the other hand, would be the intravenous solution the nurse should question because after the dextrose is metabolized, the remaining solution becomes hypotonic to the body's cells, which could lead to cerebral edema (swelling of the brain).