A nurse is caring for a client who has hypernatremia and is receiving intravenous (IV) hypotonic fluid replacement. Which of the following manifestations should the nurse understand is an indication of an adverse effect from the administration of hypotonic fluids?

The client has developed confusion.

The client's serum sodium is 140 mEq/L (135 to 145 mEq/L).

The client has a positive Chvostek's sign.

The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL).

Answer and Explanation

The Correct Answer is A

A. The client has developed confusion: Hypotonic fluids can cause a rapid shift of water into cells, potentially leading to cerebral edema. This can manifest as confusion or altered mental status, which is a serious adverse effect requiring immediate attention.

B. The client's serum sodium is 140 mEq/L (135 to 145 mEq/L): A serum sodium level within the normal range indicates that the hypotonic fluid therapy is likely effective in correcting hypernatremia, and does not suggest an adverse effect.

C. The client has a positive Chvostek's sign: A positive Chvostek's sign is indicative of hypocalcemia rather than an adverse effect of hypotonic fluid administration. This sign is related to low calcium levels and is not a direct result of hypotonic fluid therapy.

D. The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL): This BUN level is within normal limits and does not suggest an adverse effect of hypotonic fluid therapy. BUN levels can be affected by various factors, but this value alone is not indicative of an adverse reaction.

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Correct Answer is D

Explanation

A. Fever: Although fever can occur with various respiratory conditions, it is not the most specific early sign of an exacerbation in pulmonary sarcoidosis.

B. Weight loss: Weight loss is a more general symptom and not specifically indicative of an exacerbation of sarcoidosis.

C. Fatigue: Fatigue is a common symptom of sarcoidosis but is not necessarily an early sign of an exacerbation.

D. Shortness of breath: Shortness of breath is a significant early indicator of exacerbation in pulmonary sarcoidosis. It reflects worsening inflammation and granuloma formation affecting lung function.

A. Dyspnea B. Chronic cough C. Wheezing D. Sputum production E. Chest tightness

Correct Answer is ["A","B","C","D"]

Explanation

A. Dyspnea: Shortness of breath or difficulty breathing is a hallmark symptom of COPD, commonly reported by patients.

B. Chronic cough: A persistent cough, often productive, is a common manifestation of COPD, reflecting the chronic inflammation and irritation of the airways.

C. Wheezing: Wheezing, a high-pitched whistling sound during breathing, is often present in COPD due to airway narrowing and obstruction.

D. Sputum production: Increased production of sputum (mucus) is typical in COPD, as the chronic inflammation leads to mucus hypersecretion.

E. Chest tightness: While chest tightness can occur in COPD, it is less common compared to the more prominent symptoms of dyspnea, chronic cough, wheezing, and sputum production.

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A nurse is caring for a client who has hypernatremia and is receiving intravenous (IV) hypotonic fluid replacement. Which of the following manifestations should the nurse understand is an indication of an adverse effect from the administration of hypotonic fluids?

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The nurse is reinforcing discharge instructions to the client with pulmonary sarcoidosis. The nurse knows that the client understands the information if the client verbalizes which early sign of exacerbation?

Correct Answer is D

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Correct Answer is ["A","B","C","D"]

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