For treatment of hypovolemic shock which IV fluid is given?

Question

Question

This question was previously asked in

KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: Normal saline at 0.9%

Rationale:

Hypovolemic shock occurs due to a significant loss of blood volume, leading to inadequate perfusion of tissues and organs. The primary goal of treatment is to restore intravascular volume and improve blood pressure and tissue perfusion.
Normal saline at 0.9% is an isotonic solution, meaning its osmolarity is similar to that of plasma. This ensures that the fluid remains in the extracellular compartment, including the intravascular space, effectively replenishing lost blood volume without causing a shift of fluids into or out of cells.
Isotonic fluids like 0.9% normal saline are the first-line intravenous fluids for treating hypovolemic shock because they help stabilize circulation and improve cardiac output rapidly.
Normal saline is widely available, safe, and commonly used in emergency and hospital settings for fluid resuscitation in cases of hypovolemic shock due to trauma, dehydration, or other causes.

Explanation of Other Options:

Normal saline at 0.45%

Rationale: Normal saline at 0.45% is a hypotonic solution. It has a lower concentration of solutes compared to plasma, causing water to move into cells. This can lead to cellular swelling and does not effectively restore intravascular volume in hypovolemic shock.
Use: Hypotonic solutions are typically used for conditions like hypernatremia or intracellular dehydration, not for fluid resuscitation in hypovolemic shock.

Dextrose at 5%

Rationale: Dextrose 5% is initially isotonic, but once the dextrose is metabolized, the solution becomes hypotonic, leading to water movement into the cells. This does not effectively increase intravascular volume and is not suitable for treating hypovolemic shock.
Use: Dextrose solutions are often used to provide calories or treat hypoglycemia, rather than for fluid resuscitation.

Normal saline at 3%

Rationale: Normal saline at 3% is a hypertonic solution. It has a significantly higher concentration of solutes compared to plasma, causing water to move out of cells into the extracellular space. While hypertonic saline can be used for severe hyponatremia, it is not appropriate for treating hypovolemic shock as it could worsen dehydration.
Use: Hypertonic saline is reserved for specific conditions like cerebral edema or severe electrolyte imbalances, not for general fluid resuscitation.

Conclusion:

Normal saline at 0.9% is the best choice for treating hypovolemic shock among the given options because it effectively restores intravascular volume without causing fluid shifts that could exacerbate the condition.
Other solutions, such as hypotonic or hypertonic fluids, are not suitable for this purpose and are used for different clinical scenarios.