Medical Surgical Labs BMP #3

Question

The nurse is caring for a client with a sodium level of 155 mEq/L. Which signs would the nurse expect the client to exhibit?

Answers

  1. Rapid, thready pulse
    • Rationale:

      This answer is not correct because a rapid and thready pulse is a sign of hyponatremia. Retention of fluid causes the heart to work harder and pump faster.

  2. Abdominal cramping
    • Rationale:

      This answer is not correct because abdominal cramping occurs when the sodium level is low. The swelling that is accompanied by hyponatremia causes abdominal pain.

  3. Headache
    • Rationale:

      This answer is not correct because hyponatremia causes the brain to swell. Brain swelling results in headache.

  4. Dry mucous membranes
    • Rationale:

      This answer is correct because hypernatremia reflects a decrease in total body water. This results in dry mucous membranes and poor skin turgor. Other signs include low-grade fever, intense thirst, tachycardia, flushed skin, restlessness, edema, and increased blood pressure.

Overview

A sodium level of 155 mEq/L places the client in hypernatremia. Signs of hypernatremia are dry mucous membranes, thirst, fatigue, confusion, flushed skin, and elevated temperature.

Explanation

Learning Outcomes

Sodium level should be between 135-145 mEq/L. A level of 155 mEq/L places the client in hypernatremia. Signs and symptoms of hypernatremia include dry mucous membranes, thirst, fatigue, confusion, flushed skin, elevated temperature, or low grade fever, edema, decreased urinary output, and hypertension. Think about it this way, “Where sodium goes, water flows.” If a client is hypernatremic, they have a high sodium level. So therefore, they are retaining fluid because where sodium goes, water “flows” or follows. So a client with hypernatremia will have signs and symptoms of water retention.

Test Taking Tip

You can use either of these mnemonics for hypernatremia: FRIED: Fever, flushed skin; restless; irritable, increased blood pressure; edema, peripheral and pitting; decreased urinary output, dry mouth or SALT: Skin flushed, agitation, low grade fever, thirst. And lastly, remember this phrase, “Where sodium goes, water flows.”

Video Rationale