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Choose the appropriate IV solution for a severely hypernatremic patient with ECFV and a sodium level of 160 mEq/L.

A. 0.9% Sodium Chloride
B. 5% Dextrose in water
C. Lactated Ringers (LR)
D. 0.45% Sodium Chloride (1/2 NS)
E. 3% Sodium Chloride
F. Saline Lock (No IV fluids)

Answer :

Final answer:

For a severely hypernatremic patient with ECFV overload, a hypotonic solution like 0.45% Sodium Chloride (1/2NS) is the best choice. It is designed to dilute the sodium in the extracellular fluid and provide relief from the symptoms of hypernatremia.

Explanation:

The most suitable intravenous (IV) solution for a severely hypernatremic patient with extracellular fluid volume (ECFV) overload and an elevated sodium level of 160mmol/L would be 0.45% Sodium Chloride (1/2NS).

To clarify, hypernatremia is a condition characterized by high sodium levels in the blood, typically above 145mmol/L. In hypernatremia, the extra-cellular fluid becomes hypertonic, leading to cellular dehydration. To counter this, a hypotonic IV solution is often chosen to promote the movement of water into cells. 0.45% Sodium Chloride solution (1/2NS) is hypotonic, hence it helps in diluting the sodium in the extra-cellular fluid.

0.9% Sodium Chloride is isotonic and doesn't change the sodium concentration significantly, while a 3% Sodium Chloride solution is hypertonic and would in fact exacerbate the condition. Dextrose 5% in water could be an option, however it's metabolized quickly by the body, leaving free water which may cause severe hyponatremia if not closely monitored.

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