A nurse is caring for a client who has hypernatremia and requires IV fluid therapy. Which solution should the nurse prepare to infuse for this client?

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.

A) Chadwick's sign: Chadwick's sign is related to pregnancy and refers to the bluish discoloration of the cervix and vaginal walls due to increased blood flow. It is not associated with calcium levels or postoperative thyroidectomy.

B) Murphy's sign: Murphy's sign is used to diagnose gallbladder inflammation or cholecystitis. It involves palpation of the right upper quadrant of the abdomen and is not related to calcium levels or thyroid surgery.

C) Babinski's sign: Babinski's sign is a neurological reflex test used to assess the presence of upper motor neuron lesions. It is not associated with calcium levels or postoperative thyroidectomy.

D) Chvostek's sign: Chvostek's sign is a clinical indicator of hypocalcemia, where tapping on the facial nerve causes twitching of the facial muscles. With the client's calcium level of 3 mg/dL, which is significantly low, Chvostek's sign would likely be positive, indicating hypocalcemia.