Practice Question
A school-age child with sickle cell disease is admitted in vaso-occlusive crisis with poor oral intake and tachycardia. Which initial IV fluid order is most appropriate?
Answer Choices:
Correct Answer:
0.9% sodium chloride
Rationale:
🔶 0.9% sodium chloride (Normal Saline) is an isotonic crystalloid that expands intravascular volume quickly, which is exactly what is needed in vaso-occlusive crisis with poor intake and tachycardia.
🔶 In sickle cell crisis, sickled RBCs become viscous and sluggish, blocking microcirculation; adequate hydration helps reduce blood viscosity and improves tissue perfusion.
🔶 Tachycardia and poor oral intake are signs of volume depletion, and NS is the safest and most effective resuscitation fluid for restoring circulating volume.
🔶 Hypotonic solutions (like 0.45% NaCl or D5W) shift fluid into the cells and do not adequately support blood pressure or perfusion in acute crisis.
🔶 LR with added potassium is risky in sickle cell patients, who may have renal impairment or already elevated potassium levels; giving extra potassium could lead to hyperkalemia and arrhythmias.
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This question is from NURSING CONCEPTS II- MIDTERM EXAM FALL 2025 which contains 98 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN Concept-Based Assessment Level Exam(s)
- Answer Choices: 4