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Lilly M. is a 44-year-old female who is transferred to the emergency department

Lilly M. is a 44-year-old female who is transferred to the emergency department

following a severe fall. She had been standing on the balcony of a four-story building and tried to balance on the railing. She fell and sustained numerous internal and external injuries. In the emergency room she was in profound hypovolemic shock. Bleeding appears to have been stopped, and rapid infusion of 2 L of normal saline has just been completed. The AGACNP knows that the next step in fluid resuscitation includes

 
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