A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution.
Which of the following findings should indicate to the nurse that the treatment is effective?

Improved cognition.

Cardiac arrhythmias absent.

Decreased vomiting.

Absent Chvostek’s sign.

Answer and Explanation

The Correct Answer is A

Hyponatremia is a condition where the sodium level in the blood is too low, which can cause confusion, lethargy, seizures, and coma. A hypertonic solution is a fluid that has a higher concentration of solutes than the blood, which can help raise the sodium level and reduce the brain swelling caused by hyponatremia. Therefore, improved cognition indicates that the treatment is effective.

Choice B. Cardiac arrhythmias absent.

Cardiac arrhythmias are not a common symptom of hyponatremia unless it is severe or rapid in onset.

Therefore, their absence does not necessarily indicate that the treatment is effective.

Choice C. Decreased vomiting.

Vomiting can be a cause or a consequence of hyponatremia, depending on the underlying condition.

Decreased vomiting may indicate that the patient is less nauseated, but it does not reflect the sodium level or the brain status.

Choice D. Absent Chvostek’s sign.

Chvostek’s sign is a facial twitching that occurs when tapping on the cheek, which indicates hypocalcemia (low calcium level).

It is not related to hyponatremia or hypertonic solution.

Normal ranges for sodium are 135 to 145 mEq/L and for calcium are 8.5 to 10.5 mg/dL.

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Correct Answer is D

Explanation

The most appropriate action for the nurse to take in this situation is:

d. Apply a warm, moist compress.

Here's why the other options are not recommended:

a. Initiate a new IV distal to the initial site:This is not the first course of action. While starting a new IV might be necessary eventually, it's crucial to address the issue at the current site first.
b. Slow the IV solution rate:Slowing the rate doesn't directly address the coolness and edema, which indicate potential infiltration or extravasation.
c. Maintain the extremity below the level of the heart:This action would actually worsen the edema by promoting fluid accumulation at the site.

Applying a warm, moist compress can help promote absorption of any leaked fluid and improve circulation at the site. However, it's important to remember that this is just one step in the process. The nurse should also:

Stop the IV infusion.
Assess the extent of the infiltration or extravasation.
Document the findings.
Elevate the affected extremity.
Consult with a physician for further instructions and potential treatment.

A. Fentanyl transmucosal. B. Lidocaine patch. C. Morphine tablet. D. Naloxone IV.

Correct Answer is A

Explanation

This is because fentanyl transmucosal is a fast-acting opioid that can be used for breakthrough pain in patients who are already receiving opioids for chronic pain. Breakthrough pain is a sudden and severe increase in pain that occurs despite the use of regular pain medication. Fentanyl transmucosal has a rapid onset of action (1-3 minutes) and a short duration of effect (1-2 hours), which makes it suitable for treating episodic pain.

Choice B. Lidocaine patch is wrong because lidocaine patch is a topical anesthetic that can be used for localized neuropathic pain, but not for acute or severe pain.

Choice C. Morphine tablet is wrong because morphine tablet is a long-acting opioid that can be used for chronic pain, but not for breakthrough pain. Morphine tablet has a slow onset of action (30-60 minutes) and a long duration of effect (3-4 hours), which makes it unsuitable for treating episodic pain.

Choice D. Naloxone IV is wrong because naloxone IV is an opioid antagonist that can reverse the effects of opioids, but not relieve pain.

Naloxone IV can cause

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A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective?

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A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution.
Which of the following findings should indicate to the nurse that the treatment is effective?