A nurse is caring for a client who has hypernatremia and is receiving intravenous (IV) hypotonic fluid replacement. Which of the following manifestations should the nurse understand is an indication of an adverse effect from the administration of hypotonic fluids?

The client has developed confusion.

The client's serum sodium is 140 mEq/L (135 to 145 mEq/L).

The client has a positive Chvostek's sign.

The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL).

Answer and Explanation

The Correct Answer is A

A. The client has developed confusion: Hypotonic fluids can cause a rapid shift of water into cells, potentially leading to cerebral edema. This can manifest as confusion or altered mental status, which is a serious adverse effect requiring immediate attention.

B. The client's serum sodium is 140 mEq/L (135 to 145 mEq/L): A serum sodium level within the normal range indicates that the hypotonic fluid therapy is likely effective in correcting hypernatremia, and does not suggest an adverse effect.

C. The client has a positive Chvostek's sign: A positive Chvostek's sign is indicative of hypocalcemia rather than an adverse effect of hypotonic fluid administration. This sign is related to low calcium levels and is not a direct result of hypotonic fluid therapy.

D. The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL): This BUN level is within normal limits and does not suggest an adverse effect of hypotonic fluid therapy. BUN levels can be affected by various factors, but this value alone is not indicative of an adverse reaction.

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Correct Answer is A

Explanation

A. "Diffusion is the movement of molecules from an area of higher concentration to an area of lower concentration.": This statement accurately describes diffusion. Molecules move down their concentration gradient from areas of higher concentration to areas of lower concentration until equilibrium is reached.

B. "Diffusion is the movement of particles between areas of equal concentrations.": Diffusion does not occur between areas of equal concentration as there is no concentration gradient to drive the movement.

C. "Diffusion is the movement of water from an area of higher concentration of water to an area of lower concentration of water.": This describes osmosis, not diffusion. Osmosis specifically refers to the movement of water across a semipermeable membrane.

D. "Diffusion is the movement of particles from an area of lower concentration of particles to an area of higher concentration of particles.": This is incorrect as diffusion occurs from higher to lower concentration, not the reverse.

A. Report new-onset muscle weakness B. Increase consumption of apples and broccoli C. Avoid salt substitutes D. Report falls, due to high risk of osteoporosis

Correct Answer is A

Explanation

A. Report new-onset muscle weakness: Hypokalemia can cause muscle weakness, cramps, and fatigue, which are important symptoms that need to be monitored. Reporting these symptoms promptly is crucial because severe hypokalemia can lead to life-threatening complications, such as respiratory failure or cardiac arrhythmias.

B. Increase consumption of apples and broccoli: While fruits and vegetables like apples and broccoli are healthy, they are not particularly high in potassium. The client should be encouraged to consume potassium-rich foods such as bananas, oranges, potatoes, and spinach to help correct hypokalemia.

C. Avoid salt substitutes: Some salt substitutes contain potassium chloride, which can actually help increase potassium levels. However, this option might be recommended in certain conditions where potassium levels need to be carefully controlled, such as in renal failure, not in hypokalemia management.

D. Report falls, due to high risk of osteoporosis: Hypokalemia does not directly increase the risk of osteoporosis. Falls may occur due to muscle weakness, but this is not specifically related to osteoporosis. Therefore, reporting falls is not the primary concern in hypokalemia.

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A nurse is caring for a client who has hypernatremia and is receiving intravenous (IV) hypotonic fluid replacement. Which of the following manifestations should the nurse understand is an indication of an adverse effect from the administration of hypotonic fluids?

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