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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?

A.

Administer hypertonic saline and restrict water intake

B.

Start fluid restriction and administer a loop diuretic

C.

Administer isotonic saline and encourage oral fluid intake

D.

Increase oral sodium intake and administer an antiemetic

Answer and Explanation

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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View Related questions

Correct Answer is B

Explanation

A. Fluid overload is not an allergic reaction but rather a complication of transfusion related to the volume of fluid administered, thus diphenhydramine would not be appropriate.

B. Urticaria, or hives, is a common mild allergic reaction that can occur during blood transfusions. Administering diphenhydramine can help prevent or treat this response.

C. Hemolysis is a serious reaction involving the destruction of red blood cells, often due to blood type incompatibility; it is not alleviated by antihistamines.

D. Fever can occur during transfusions but is typically due to non-specific immune reactions and does not respond to diphenhydramine.

Correct Answer is B

Explanation

A. Metabolic alkalosis is characterized by an increased pH and increased HCO3 levels, which does not fit the provided values.

B. The low HCO3 of 18 mEq indicates a metabolic acidosis, as the body is unable to retain enough bicarbonate to balance the acid levels, and the pH is also low at 7.30, confirming acidosis.

C. Respiratory alkalosis would show a high pH and low PaCO2, which is not the case here.

D. Respiratory acidosis would be indicated by a high PaCO2 and a low pH, but the HCO3 level is low, indicating a metabolic issue rather than a respiratory one.

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