Assignment task:
B.J. is 62-year-old male patient with a history of alcoholism. Presently, he has 3+ pitting edema from mid-calf to his toes bilaterally. B.J. had a protuberant abdomen filled with ascitic fluid with an abdominal girth as much as 60 inches. BJ's respiratory status was compromised because the fluid was pushing up on his diaphragm and restricted room for his lungs to fully ventilate. A paracentesis was performed, and abdomen is still distended with fluid, but girth is now only 45 inches, and his respiratory effort/ventilation improved. Serous fluid seeps from the paracentesis site. His liver function test result was markedly elevated, and his albumin is 2.0 g/dL; Na 134 mEq/L. BP 120/80, HR - 100; RR 22; O2 sat 95% on room air, urine output averaging 35 mL/hr.
The Health care provider has ordered IV therapy for the patient. Which one of the following orders would the nurse expect for BJ?
1. 0.45% NaCl infusion @ 125 mL x 8 hours
2. 3% NaCl fluid bolus 125 mL over 1 hour
3. 250 mL normal saline bolus to infuse over 1 hour.
4. 25% Albumin (100 mL bottle) to infuse over 1 hour- daily x 3 days