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. Gingivitis is a form of gum disease that can occur in anyone, but it is not specifically related to low CD4-T-cell counts associated with AIDS.
B. Candidiasis, also known as oral thrush, is a fungal infection caused by Candida species. Clients with a significantly decreased CD4-T-cell count are at high risk for opportunistic infections, including candidiasis, due to their compromised immune systems.
C. Xerostomia refers to dry mouth, which can occur for various reasons but is not specifically an infectious condition linked to low CD4 counts.
D. Halitosis, or bad breath, can result from several factors, including poor oral hygiene or underlying health issues, but is not specifically linked to the immune status of a client with AIDS.
Correct Answer is D
Explanation
A. Increasing the infusion rate may exacerbate the patient's symptoms and does not address the potential toxicity from the furosemide.
B. Normal potassium levels indicate that potassium supplementation is unnecessary and does not address the dizziness and ringing in the ears, which could suggest ototoxicity from furosemide.
C. While reassurance can help, the patient's symptoms indicate a potential adverse reaction to the medication that should not be ignored.
D. Stopping the furosemide infusion and notifying the provider is the most appropriate action due to the risk of ototoxicity and the need for further evaluation of the patient's symptoms.