问题 单项选择题

The nurse provides fluid replacement for a client with burns on 35% of his body. It has been 12 hours since the burns occurred. His blood pressure is 85/60 mmHg. His pulse is 124 beats/minute. Urine output was 25 mL during the past hour. What orders should the nurse expect to receive from the physician

A. Maintain IV fluids at the present rate, and continue to reassess vital signs and urine output hourly.
B. Increase the IV rate, and continue to reassess vital signs and urine output hourly.
C. Decrease the IV rate, and continue to reassess vital signs and urine output hourly.
D. Administer a vasoconstrictor, and reassess vital signs and urine output hourly.

答案

参考答案:B

解析:During the first 24 hours after a burn, interstitial and intracellular fluid shifts occur and intravascular fluid volume decreases. Hypovolemia calls for fluid replacement therapy to maintain vital organ perfusion. Keeping IV fluids at the current rate wouldn’t correct the client’s fluid deficit. A vasoconstrictor would be inappropriate because it doesn’t correct fluid volume deficits.

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