The nurse is caring for a client with severe bleeding from a wound. Which of the following intravenous solutions would the client most likely receive initially?

A. Dextrose 5% in water (D5W) is a hypotonic solution once dextrose is metabolized. It primarily provides free water for cellular hydration but does not expand intravascular volume effectively, making it inappropriate for acute blood loss. B. Lactated Ringer’s (LR) is an isotonic crystalloid that closely resembles plasma electrolyte composition. It is ideal for rapid intravascular volume replacement in clients with acute hemorrhage, helping to restore blood pressure and perfusion until blood products can be administered. C. This solution is hypotonic (0.45% NaCl) and will shift into cells rather than remain in the vascular space. It is not suitable for initial resuscitation of a hemorrhaging client, as it does not adequately expand circulating volume. D. There is no standard 33% saline solution used in clinical practice. Hypotonic saline solutions are not used for acute volume replacement in severe bleeding.