36. The treatment for a client suffering from hypovolemic shock following extensive burns will focus on controlling fluid loss and replacing fluid volume. A nurse should expect the client with burns to receive solutions that expand volume. To pull fluid from the interstitial spaces, which solutions should the nurse prepare? Select all that apply.
. A unit of whole blood.
. Hespan (hetastarch).
. Albumin.
. Lactated Ringer's.
. Packed red blood cells.
Test-Taking Tip
Look for a solution that will increase osmotic (pull) pressure in the intravascular (venous) system.
Content Area: Adult Health, Fluid and Electrolyte Imbalances; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is incorrect because volume will increase, but fluid will not be pulled from the tissue. Answer 2 is correct because this solution is classified as a hypertonic volume expander, pulling fluids from the tissues. Answer 3 is correct because albumin is a hypertonic solution and will increase the osmotic pressure, pulling fluid into the vascular space. Answer 4 is incorrect because lactated Ringer's is considered to be isotonic, not causing any shift of fluids. Volume will increase, but fluid will remain in the tissues. Answer 5 is incorrect because packed red blood cells improve oxygen-carrying capacity, but not volume.