A nurse is caring for a client in the emergency department. Complete the following sentence by using the lists of options The nurse should administer a total of dropdown 0.9% sodium chloride in the first hour, and then dropdown each subsequent hour.

Rationale for correct choices • 1320 mL: The client’s weight is 88 kg, and the prescription is to administer 0.9% sodium chloride at 15 mL/kg for the first hour. Calculating: 88 kg × 15 mL/kg = 1,320 mL. This volume addresses the significant dehydration seen in hyperglycemia and early diabetic ketoacidosis, helping restore intravascular volume and perfusion. Rapid fluid replacement in the first hour is essential to correct hypotension and improve kidney perfusion. • 880 mL: After the initial hour, the prescription reduces to 10 mL/kg/hr. Calculating the subsequent rate: 88 kg × 10 mL/kg = 880 mL/hr. Continuing isotonic fluid at this rate maintains hydration while avoiding fluid overload. This stepwise approach ensures ongoing correction of dehydration and electrolyte balance without causing abrupt volume shifts. Rationale for incorrect choices • 1230 mL: This value underestimates the prescribed 15 mL/kg for an 88 kg client, potentially leaving the client under-resuscitated. Insufficient fluid replacement could prolong hypotension, impair renal perfusion, and worsen hyperglycemia complications. Accurate weight-based calculation ensures effective initial volume resuscitation. • 1032 mL: This value underestimates the maintenance rate of 10 mL/kg/hr, which could result in inadequate ongoing fluid replacement. Suboptimal fluid management may lead to continued dehydration, persistent hypernatremia, and slower correction of the hyperglycemic state. Proper calculation ensures safe and effective maintenance therapy. • 808 mL: This volume underestimates the correct hourly fluid replacement after the initial bolus. Administering 808 mL instead of 880 mL would provide insufficient hydration, prolonging the hyperglycemic state and delaying metabolic stabilization. Proper calculation ensures safe and effective fluid therapy. • 888 mL: While 888 mL is close to the calculated 880 mL, it slightly exceeds the prescribed 10 mL/kg/hr rate. Over-infusion could risk volume overload, particularly in clients with borderline cardiac or renal function. Maintaining precise dosing per protocol ensures safe, controlled hydration in DKA management.