A 65-year-old female presents with confusion, headache, and muscle weakness. Her sodium level is 120 mEq/L. Which of the following interventions is most appropriate based on her condition?
Administer hypertonic saline and restrict water intake
Start fluid restriction and administer a loop diuretic
Administer isotonic saline and encourage oral fluid intake
Increase oral sodium intake and administer an antiemetic
The Correct Answer is A
A. Administering hypertonic saline (3% NaCl) is appropriate for treating severe hyponatremia, as it helps to raise sodium levels safely. Restricting water intake is also necessary to prevent further dilution of sodium.
B. Fluid restriction with a loop diuretic may not be effective in this scenario and can worsen the hyponatremia by causing further fluid loss without addressing the sodium levels.
C. Isotonic saline is not indicated for correcting severe hyponatremia, and encouraging oral fluid intake could exacerbate the condition.
D. Increasing oral sodium intake is not sufficient for immediate correction of severe hyponatremia and does not address the acute nature of the client’s symptoms.
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Correct Answer is B
Explanation
A. Metabolic acidosis would be indicated by a low pH and a low HCO3, which is not present in this case since HCO3 is normal.
B. The pH of 7.32 indicates acidemia, and a PaCO2 of 50 mmHg suggests respiratory acidosis as the body is retaining carbon dioxide, contributing to the low pH. The HCO3 is normal, indicating that there is no metabolic compensation occurring.
C. Respiratory alkalosis would show a high pH and low PaCO2, which is not the case here.
D. Metabolic alkalosis would present with a high pH and elevated HCO3, which is also not present in these ABG results.
Correct Answer is B
Explanation
A. In the assembly stage, other proteins and enzymes are involved in the packaging of viral components into new virions, not integrase.
B. During the integration stage, integrase is essential as it inserts the newly formed viral DNA into the host's genome, enabling the virus to utilize the host's cellular machinery for replication.
C. Integrase does not participate in the entry stage; this stage is facilitated by other proteins that aid in the fusion of the virus with the host cell membrane.
D. Integrase is not involved in reverse transcription; that process is facilitated by the enzyme reverse transcriptase, which converts viral RNA into DNA.