A nurse in the emergency department is assessing a young adult client who was administered a hypotonic IV fluid bolus for rehydration after collapsing at an athletic event. Which of the following findings indicates the client is experiencing water intoxication?

Choice A rationale:
Changing the IV tubing for TPN solution every 72 hr is not necessary unless there is a complication or a specific reason to do so. TPN tubing should be changed based on the facility's protocol and the patient's condition, not on a fixed time frame.
Choice B rationale:
This choice is the correct answer. TPN solutions are susceptible to bacterial growth due to their nutrient-rich composition. Discarding any remaining TPN solution after 24 hr helps minimize the risk of bacterial contamination and subsequent infection in the patient.
Choice C rationale:
Changing the dressing around the IV site weekly is a common practice for peripheral IV sites, but TPN administration usually requires a more frequent dressing change due to the higher risk of infection associated with central venous access.
Choice D rationale:
Removing TPN from the refrigerator 5 min before infusing it is unnecessary. TPN solutions are typically stored in a refrigerator and should be brought to room temperature gradually before administration. However, 5 minutes is not sufficient time for the solution to reach an appropriate temperature.

Choice Arationale:
A white blood cell (WBC) count of 5,200/mm3 is within the normal range, which typically varies but is approximately 4,500-11,000/mm3. This result indicates a normal immune response and does not require provider notification.

Choice Brationale:
A hemoglobin (Hgb) level of 14 g/dL falls within the normal range for adults, which is generally between 12-16 g/dL for women and 13.5-17.5 g/dL for men. This result is not a cause for concern, and the nurse does not need to notify the provider about it.

Choice C rationale:
A potassium (K+) level of 3.2 mEq/L is considered hypokalemia. The normal range for potassium is around 3.5-5.0 mEq/L. Hypokalemia can lead to cardiac dysrhythmias, muscle weakness, and other serious complications. The nurse should notify the provider to address this electrolyte imbalance promptly.
Choice D rationale:
A magnesium (Mg) level of 1.6 mEq/L is below the normal range of approximately 1.7-2.2 mEq/L. While mild hypomagnesemia might not require immediate intervention, it's important to monitor and potentially address this electrolyte imbalance, especially if the client's symptoms worsen. However, it does not warrant immediate notification of the provider.