A high risk pregnant patient has had a complicated delivery and is in the recovery room with active bleeding. The physician has ordered the IV infusion hetastarch in sodium chloride (Hespan). Which best describes the indications for this fluid?

 

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Correct

- Increasing plasma volume during shock or bleeding

- Causing blood coagulation to promote blood clotting

- Improving circulation by causing vasodilation

- Increasing cardiac contractility to improve circulation

Rationale

"Increasing plasma volume during shock or bleeding" is correct. Hetastarch in sodium chloride (Hespan) is a type of plasma expanding colloid that is used to increase fluid volume in the intravascular system during blood loss. Hetastarch in sodium chloride is typically used for volume replacement to prevent complications of severe hemorrhage, such as hypovolemic shock.

"Causing blood coagulation to promote blood clotting" is incorrect because the indication of hetastarch in sodium chloride is to expand volume. It does not cause blood coagulation.

"Improving circulation by causing vasodilation" is incorrect because hetastarch in sodium chloride does not cause vasodilation. It is simply a volume expander.

"Increasing cardiac contractility to improve circulation" is incorrect because hetastarch in sodium chloride does not increase cardiac contractility.

References:
Hespan, Hextend (hetastarch) Drug Side Effects, Interactions, and Medication Information on eMedicineHealth. (n.d.). Retrieved May 1, 2018, from https://www.emedicinehealth.com/drug-hetastarch/article_em.htm

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