Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What should the PACU nurse anticipate administering to a patient who displays signs of fluid overload and hyponatremia after a TURP procedure?

1. Lactated ringer's solution and midazolam IV

2. D5W with potassium 20 meq/L and diazepam IV

3. 3% sodium chloride and furosemide IV

4. Normal saline and morphine sulfate IV

The correct answer is: 3% sodium chloride and furosemide IV

The administration of 3% sodium chloride and furosemide IV is appropriate for a patient exhibiting signs of fluid overload and hyponatremia following a TURP (transurethral resection of the prostate) procedure. In this clinical scenario, the patient is likely experiencing an excess of fluid in the body, which can dilute sodium levels, leading to hyponatremia. The use of 3% sodium chloride is a hypertonic saline solution that can help to increase serum sodium concentrations effectively. It is critical to carefully administer hypertonic saline under close monitoring to prevent rapid shifts in sodium levels, which can pose additional risks. Furosemide, a loop diuretic, provides a dual benefit; it aids in the reduction of fluid overload by promoting diuresis, which decreases total body fluid, helping to normalize the patient's fluid balance. This combination is essential for managing both the fluid overload and the hyponatremia, addressing the underlying issues that the patient is experiencing after the TURP procedure. The other options do not adequately address both fluid overload and hyponatremia. For instance, administering lactated Ringer's solution or D5W risks exacerbating fluid overload, as these fluids can