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 C

Explanation

A. Respiratory alkalosis: Respiratory alkalosis is generally associated with hyperventilation and is not directly caused by tension pneumothorax. In tension pneumothorax, the primary issues are related to pressure changes within the thoracic cavity, not respiratory alkalosis.

B. Increased venous return: In tension pneumothorax, venous return is actually decreased due to the increased intrathoracic pressure compressing the great vessels, which impedes blood flow back to the heart.

C. Decreased cardiac output: Tension pneumothorax causes a significant increase in intrathoracic pressure, leading to compression of the heart and great vessels, which results in decreased venous return and ultimately decreased cardiac output. This is a critical and life-threatening consequence of tension pneumothorax.

D. Dilated ventricles: Dilated ventricles are more commonly seen in chronic heart conditions such as heart failure, rather than in acute tension pneumothorax. Tension pneumothorax typically results in reduced ventricular filling rather than dilation.

A. Hepatitis B B. Cockroaches C. Radon D. Mold

Correct Answer is D

Explanation

A. Hepatitis B is a viral infection that affects the liver, not an environmental factor associated with asthma or allergies. Avoiding Hepatitis B would be unrelated to managing asthma or allergies.
B. Cockroaches can trigger asthma symptoms, particularly through their droppings and shed body parts, which are common allergens. However, while significant, mold is often a more pervasive and impactful trigger, especially in damp environments.
C. Radon is a radioactive gas that can increase the risk of lung cancer over time but is not directly linked to asthma or allergies. It is an environmental concern but not specifically for managing asthma or allergies.
D. Mold is a well-known allergen that can exacerbate asthma symptoms. Mold spores, which are often found in damp environments, can cause significant respiratory issues and should be avoided by individuals with asthma and allergies.

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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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