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 D
Explanation
A. The conversion of RNA into DNA is a critical step in the HIV lifecycle, but it does not directly lead to opportunistic infections; instead, it allows the virus to integrate into the host’s genome.
B. Having reverse transcriptase enzyme is a characteristic of retroviruses like HIV that facilitates replication, but it does not cause opportunistic infections directly.
C. HIV containing a single strand of genetic material is a feature of its classification as a retrovirus but is not related to the risk of opportunistic infections.
D. The ability of HIV to target and destroy CD4 lymphocytes is the key reason for opportunistic infections. CD4 cells are crucial for the immune response, and their depletion leads to immunosuppression, making the client susceptible to infections that would not typically affect an individual with a healthy immune system.
Correct Answer is D
Explanation
A. Encouraging oral intake may not be effective due to the patient's likely need for more rapid rehydration given his low blood pressure and heart rate.
B. A potassium-sparing diuretic is inappropriate in this situation, as the patient is already experiencing fluid loss and requires rehydration, not diuresis.
C. Restricting fluid intake would be contraindicated as the patient is in a state of dehydration and hypotension.
D. Administering an IV bolus of normal saline is the priority intervention to quickly restore fluid volume and improve blood pressure and hydration status.