Medical Surgical Sodium Na+ #3

Question

The nurse evaluates which client to be at risk for developing hypernatremia?

Answers

  1. 39-year-old with diarrhea and vomiting
    • Rationale:

      This answer is not correct because diarrhea and vomiting cause both sodium and water losses; therefore, hypernatremia is not expected for this client.

  2. 50-year-old with pneumonia, diaphoresis, and high fevers
    • Rationale:

      This answer is correct because pneumonia often causes high fevers thus increasing the risk for diaphoresis; therefore, this client is at risk for hypernatremia.

  3. 62-year-old with congestive heart failure taking loop diuretics
    • Rationale:

      This answer is not correct because loop diuretics are more likely to result in hypovolemic hyponatremia, not hypernatremia. The client would also lose potassium when taking loop diuretics.

  4. 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone (SIADH)
    • Rationale:

      This answer is not correct because clients with syndrome of inappropriate antidiuretic hormone (SIADH) have hyponatremia (not hypernatremia) due to increased water reabsorption in the renal tubules.

Overview

Hypernatremia is defined as serum sodium level greater than 145 mEq/L. The normal range for serum sodium is 135 to 145 mEq/L.

Explanation

Learning Outcomes

The normal range for serum sodium is 135 to 145 mEq/L. Hypernatremia often implies a deficit of total body water relative to total body sodium caused by water intake being less than water losses. Diaphoresis and a high fever can lead to free water loss through the skin, resulting in hypernatremia; therefore, the nurse should evaluate the 50-year-old with pneumonia, diaphoresis, and high fevers for this condition.

Test Taking Tip

Consider the risk factors for developing hypernatremia to answer this question correctly.

Video Rationale