Advanced Emergency Medical Technician (AEMT) Practice Test

Which of the following is a contraindication to administering large quantities of isotonic crystalloid solutions such as lactated Ringer's and normal saline?

1. Traumatic injuries

2. Dehydration

3. Congestive heart failure

4. Anaphylactic shock

The correct answer is: Congestive heart failure

Administering large quantities of isotonic crystalloid solutions, such as lactated Ringer's or normal saline, can be particularly problematic in patients with congestive heart failure. This condition is characterized by the heart's inability to pump blood effectively, which can lead to fluid overload. When large volumes of fluid are introduced into the circulatory system in these patients, it can exacerbate heart failure symptoms, causing further stress on a compromised cardiac function. This can lead to pulmonary congestion and edema, heightening the risk of respiratory distress. In contrast, traumatic injuries and dehydration usually require aggressive fluid resuscitation strategies to manage shock and restore normal physiological parameters. Anaphylactic shock is treated primarily with epinephrine and, while fluid resuscitation may be necessary, isotonic crystalloids do not pose the same direct risk of exacerbating a cardiac condition as they do in congestive heart failure. Thus, the particular vulnerability of patients with congestive heart failure makes this a critical consideration when determining appropriate fluid management strategies.