Which nursing actions are key for severe hypernatremia?

Which nursing actions are key for severe hypernatremia?

• A. Identify cause, correct gradually with IV fluids, monitor mental status, prevent rapid shifts
• B. Correct sodium rapidly with hypertonic saline
• C. Administer diuretics immediately
• D. Withhold fluids to prevent edema

Answer: (B)

Severe hypernatremia is treated by restoring the body's water balance gradually while addressing the underlying cause, and by watching for changes in mental status as you rehydrate. The key nursing actions are to identify what caused the high sodium, correct the water deficit slowly with appropriate IV fluids, monitor the patient's mental status and neuro status, and prevent rapid shifts in sodium that could injure the brain. Rapidly correcting sodium with hypertonic saline would worsen hypernatremia and increase the risk of osmotic injury, so that approach is not appropriate. Withholding fluids would worsen dehydration, and diuretics would typically worsen sodium concentration unless there is a specific, separate indication after volume is restored. In practice, you’d assess volume status, give IV fluids to rehydrate (often starting with isotonic saline if hypovolemic, then switching to a hypotonic solution to lower sodium gradually), and carefully monitor electrolytes, intake/output, and mental status, aiming for a slow, controlled decrease in serum sodium.

Severe hypernatremia is treated by restoring the body's water balance gradually while addressing the underlying cause, and by watching for changes in mental status as you rehydrate. The key nursing actions are to identify what caused the high sodium, correct the water deficit slowly with appropriate IV fluids, monitor the patient's mental status and neuro status, and prevent rapid shifts in sodium that could injure the brain. Rapidly correcting sodium with hypertonic saline would worsen hypernatremia and increase the risk of osmotic injury, so that approach is not appropriate. Withholding fluids would worsen dehydration, and diuretics would typically worsen sodium concentration unless there is a specific, separate indication after volume is restored. In practice, you’d assess volume status, give IV fluids to rehydrate (often starting with isotonic saline if hypovolemic, then switching to a hypotonic solution to lower sodium gradually), and carefully monitor electrolytes, intake/output, and mental status, aiming for a slow, controlled decrease in serum sodium.