Which of the following is an effective initial resuscitation fluid for severe hypovolemic hypernatremia?

In cases of severe hypovolemic hypernatremia, the primary goal of initial resuscitation is to restore intravascular volume while also addressing the elevated sodium levels. Normal saline (0.9% sodium chloride) is considered an effective initial resuscitation fluid because it closely resembles the body's plasma sodium concentration, helping to expand intravascular volume efficiently.

While hypertonic solutions can be used for acute situations, normal saline effectively rehydrates the patient without adding additional sodium, which is crucial since hypernatremia is characterized by an excess of sodium relative to water. This approach helps prevent rapid shifts in sodium levels that could lead to complications such as cerebral edema if corrections are done too quickly. Additionally, volume expansion with normal saline can help improve renal perfusion and support effective sodium excretion.

Other options, like 5% dextrose, could contribute to further dilution of sodium but wouldn't effectively address the hypovolemia. Lactated Ringer’s solution contains electrolytes that might disturb the sodium balance, and colloids do not provide adequate volume resuscitation in cases of hypovolemic hypernatremia because they contain larger molecules that do not effectively restore extracellular fluid volume like saline does. Hence, normal saline is