A nurse is caring for a client who has hypernatremia and requires IV fluid therapy. Which solution should the nurse prepare to infuse for this client?

A) Isotonic solution: Isotonic solutions, such as 0.9% sodium chloride, maintain the current sodium levels and fluid balance but do not correct hypernatremia. They are not suitable for lowering elevated sodium levels.

B) Total Parenteral Nutrition (TPN): TPN is used for providing comprehensive nutritional support and does not address electrolyte imbalances such as hypernatremia. It is not used to manage sodium levels directly.

C) Hypertonic solution: Hypertonic solutions, such as 3% sodium chloride, increase sodium levels and are used for treating hyponatremia or specific conditions requiring higher sodium concentrations. They would worsen hypernatremia.

D) Hypotonic solution: Hypotonic solutions, like 0.45% sodium chloride (half-normal saline) or Dextrose 5% in water (D5W), are appropriate for treating hypernatremia. They help dilute the sodium concentration in the blood and aid in correcting the elevated sodium levels

A) Hyperactive bowel sounds: Hypercalcemia typically leads to decreased gastrointestinal motility, not increased. Clients with elevated calcium levels may experience constipation, abdominal pain, or ileus due to the relaxing effect of calcium on smooth muscle. Therefore, hyperactive bowel sounds are not a common finding in hypercalcemia.

B) Increased blood clots: Hypercalcemia can promote a hypercoagulable state, increasing the risk of thromboembolic events. This occurs because high calcium levels can enhance platelet aggregation and increase the coagulability of blood. Therefore, a client with elevated serum calcium may have an increased risk of developing blood clots.

C) Hyperactive deep tendon reflexes: Hypercalcemia generally leads to reduced neuromuscular excitability, which may manifest as decreased or absent deep tendon reflexes, muscle weakness, and lethargy. Hyperactive reflexes are more commonly associated with hypocalcemia, which causes increased neuromuscular excitability.

D) Positive Chvostek’s sign: Chvostek's sign is a clinical indicator of hypocalcemia, not hypercalcemia. It involves twitching of the facial muscles in response to tapping the facial nerve and is due to increased neuromuscular excitability caused by low calcium levels. Hypercalcemia, conversely, does not typically present with a positive Chvostek’s sign.