A nurse is planning care for a client who has hypernatremia. Which of the following interventions should the nurse include in the plan?

• Choice A reason:

• Administering hypotonic IV fluids is an appropriate intervention for a client who has hypernatremia. Hypotonic fluids have a lower concentration of solutes than the blood, so they can help dilute the excess sodium and rehydrate the cells.

• Choice B reason:

• Monitoring blood glucose levels is not directly related to hypernatremia, although it may be indicated for other reasons, such as diabetes. Hypernatremia can be caused by uncontrolled diabetes, but it is not a consequence of high blood glucose levels.

• Choice C reason:

• Providing oral care every 4 hours is a supportive measure for a client who has hypernatremia, but it is not a specific intervention to correct the electrolyte imbalance. Oral care can help relieve thirst and dry mouth, which are common symptoms of hypernatremia, but it does not address the underlying cause of fluid loss or sodium gain.

• Choice D reason:

• Increasing dietary intake of potassium is not helpful for a client who has hypernatremia. Potassium is another electrolyte that plays a role in fluid balance and nerve function, but it is not affected by hypernatremia. In fact, increasing potassium intake may worsen the condition by causing further dehydration or hyperkalemia (high potassium levels)

Choice A reason:

A client who has chronic kidney disease should limit the intake of bananas and oranges because they are high in potassium, which can accumulate in the blood and cause hyperkalemia. Hyperkalemia can lead to cardiac arrhythmias and muscle weakness.

Choice B reason:

A client who has chronic kidney disease should not drink at least 3 liters of water every day because this can cause fluid overload and hypertension. Fluid overload can worsen the kidney function and increase the risk of heart failure and pulmonary edema. Hypertension can damage the blood vessels and organs.

Choice C reason:

A client who has chronic kidney disease should not eat more cheese and yogurt because they are high in phosphorus, which can bind with calcium and cause hypocalcemia and hyperphosphatemia. Hypocalcemia can lead to muscle cramps, tetany, and osteoporosis. Hyperphosphatemia can cause soft tissue calcification and itching.

Choice D reason:

A client who has chronic kidney disease should not use salt substitutes instead of table salt because they often contain potassium chloride, which can also increase the potassium level in the blood and cause hyperkalemia. Salt substitutes are not recommended for clients who have kidney disease or who are on potassium-sparing diuretics.