A female client with RLQ abdominal pain and possible ectopic pregnancy experiences hypotension and tachycardia; which IV solution should be initiated while awaiting definitive care?

A female client with RLQ abdominal pain and possible ectopic pregnancy experiences hypotension and tachycardia; which IV solution should be initiated while awaiting definitive care?

• A. Lactated Ringer's (LR) at 150 mL/hour.
• B. Normal Saline (NS) at 20 mL/hour.
• C. D5W/0.45 NS at 125 mL/hour.
• D. Dextrose 10% (D10W) at 83 mL/hour.

Answer: (B)

Rapid isotonic crystalloid infusion is the priority when there is suspected hemorrhagic shock from an ectopic pregnancy. Normal saline is an isotonic crystalloid that quickly expands the intravascular volume without shifting fluid into cells or adding glucose. Starting this type of solution helps restore perfusion while definitive care is arranged, which is exactly what’s needed in a hypotensive, tachycardic patient with suspected ectopic pregnancy. Other options either don’t provide the needed rapid intravascular volume expansion or introduce fluids that aren’t ideal for shock. Solutions with dextrose (even when small amounts) don’t reliably sustain intravascular volume and can worsen glycemic control during acute stress. Dextrose-containing fluids also shift out of the intravascular space as glucose is metabolized. A solution that’s not dextrose-based and stays within the vascular compartment is preferred for initial resuscitation. Dextrose-containing fluids and hypotonic mixes are not suitable for rapid volume expansion in this scenario.

Rapid isotonic crystalloid infusion is the priority when there is suspected hemorrhagic shock from an ectopic pregnancy. Normal saline is an isotonic crystalloid that quickly expands the intravascular volume without shifting fluid into cells or adding glucose. Starting this type of solution helps restore perfusion while definitive care is arranged, which is exactly what’s needed in a hypotensive, tachycardic patient with suspected ectopic pregnancy.

Other options either don’t provide the needed rapid intravascular volume expansion or introduce fluids that aren’t ideal for shock. Solutions with dextrose (even when small amounts) don’t reliably sustain intravascular volume and can worsen glycemic control during acute stress. Dextrose-containing fluids also shift out of the intravascular space as glucose is metabolized. A solution that’s not dextrose-based and stays within the vascular compartment is preferred for initial resuscitation. Dextrose-containing fluids and hypotonic mixes are not suitable for rapid volume expansion in this scenario.