Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Which fluid resuscitation method should be avoided in cases of postoperative bleeding?

1. Normal saline

2. Dextrose

3. Hartmann's solution

4. Dextran

The correct answer is: Dextran

In the context of postoperative bleeding, dextran should be avoided as a fluid resuscitation method primarily due to its potential adverse effects, particularly in patients who may have bleeding complications. Dextran, which is a colloid, can cause a dilution effect of the blood's coagulation factors and interfere with platelet function, leading to worse bleeding outcomes. Additionally, dextran can lead to anaphylactic reactions in some patients and may also cause kidney damage, particularly in those with pre-existing renal issues or dehydration, which can be a concern after surgery. In contrast, other fluid resuscitation options like normal saline and Hartmann's solution are generally safer choices in the context of managing postoperative bleeding, as they do not carry the same risks associated with coagulation impairment. Dextrose, while it provides energy, is also not commonly used for resuscitating cases of bleeding due to the lack of volume expansion or the appropriate electrolyte composition needed to support recovery.