A nurse is caring for a patient whose sodium level is 118 mEq/L. Which nursing diagnosis is a priority for this patient?

Choice A: Anticipating the administration of intravenous sodium bicarbonate is incorrect because this would increase the pH and worsen the alkalosis. Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis.

Choice B: Preparing to start an intravenous fluid bolus using isotonic fluids is incorrect because this would not affect the pH or the PaCO2. Isotonic fluids are used to treat fluid volume deficit, not respiratory alkalosis.

Choice C: Immediately administering oxygen via a mask and monitoring oxygen saturation is incorrect because this would decrease the respiratory drive and increase the PaCO2. Oxygen therapy is used to treat hypoxemia, not respiratory alkalosis.

Choice D: Encouraging the patient to breathe in and out slowly into a paper bag is correct because this would increase the PaCO2 and lower the pH. Rebreathing carbon dioxide is a common treatment for respiratory alkalosis caused by hyperventilation.

Choice A: Comfort, Impaired is not a priority nursing diagnosis for this patient, because this condition is not directly related to the low sodium level. Comfort, Impaired is a state of physical or psychological discomfort that can affect the patient's well-being and quality of life.

Choice B: Disturbed Sensory Perception is a priority nursing diagnosis for this patient, because this condition is a serious complication of the low sodium level. Disturbed Sensory Perception is a state of altered or impaired perception of reality that can affect the patient's cognitive and neurological functions. Low sodium level can cause cerebral edema, which is a swelling of the brain that can lead to confusion, seizures, coma, and death.

Choice C: Deficient Fluid Volume is not a priority nursing diagnosis for this patient, because this condition is not the cause of the low sodium level. Deficient Fluid Volume is a state of decreased intravascular, interstitial, or intracellular fluid that can affect the patient's fluid and electrolyte balance. Low sodium level can be caused by excess fluid intake, fluid retention, or loss of sodium from the body.

Choice D: Risk for Injury is not a priority nursing diagnosis for this patient, because this condition is not specific to the low sodium level. Risk for Injury is a state of vulnerability to physical or psychological harm that can affect the patient's safety and health. Low sodium level can increase the risk of injury from falls, accidents, or seizures.