A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?

Choice A rationale: Cardiac arrhythmias are a concern with severe hyponatremia but might not directly indicate treatment effectiveness.
Choice B rationale: While vomiting might improve with treatment, it's not a definitive indicator of correcting hyponatremia.
Choice C rationale: Chvostek's sign is more associated with calcium imbalances, not sodium levels.
Choice D rationale: Hyponatremia can cause neurological symptoms due to brain swelling. Improving cognition indicates that the hypertonic solution is likely correcting the low sodium levels and reducing brain swelling.

A. Determine factors that led to the omission: While determining the factors that led to the omission is important for preventing future errors, it is not the immediate priority when a medication has been missed. Assessing the client for adverse reactions takes precedence to ensure their safety and well-being.

B. Assess the client for adverse reactions: Assessing the client for adverse reactions is the immediate priority when a medication has been missed. This allows the nurse to promptly identify any potential harm or complications resulting from the missed dose and take appropriate actions to mitigate them.

C. Report the missed dosage to the client's provider: Reporting the missed dosage to the client's provider is important for documentation and continuity of care, but it should follow the assessment of the client for adverse reactions. Immediate assessment of the client's condition takes precedence to address any immediate concerns.

D. File an incident report: Filing an incident report is necessary for documenting the missed dosage and analyzing the factors that contributed to the error. However, it should be done after assessing the client for adverse reactions and reporting the incident to the provider. The incident report helps in identifying system issues and implementing measures to prevent similar errors in the future.