A nurse is caring for a client who is receiving oxygen when a fire starts in an adjacent room. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

A. Hypertension: Hyponatremia typically does not cause high blood pressure. In fact, low sodium levels can lead to fluid shifts and hypotension in severe cases, rather than hypertension. Monitoring blood pressure is important, but hypertension is not an expected finding of hyponatremia.

B. Blurred vision: Blurred vision is not a classic symptom of hyponatremia. While severe electrolyte imbalances can affect neurological function, visual changes are more commonly associated with hypernatremia or other conditions affecting the eyes.

C. Constipation: Constipation is not directly linked to low sodium levels. Hyponatremia primarily affects neuromuscular and neurological function, rather than gastrointestinal motility.

D. Muscle cramps: Muscle cramps are a common manifestation of hyponatremia due to the disruption of sodium’s role in neuromuscular excitability. Low sodium levels can cause involuntary muscle contractions, weakness, and twitching.

A. Answers questions asked by the nurse: Responding verbally shows the child is engaged and able to understand and participate in the interaction, indicating readiness to cooperate during the assessment.

B. Plays with toys in the examining room: While playing indicates comfort in the environment, it may also reflect distraction or avoidance rather than readiness to cooperate with the nurse’s instructions. Play alone is not a reliable indicator of cooperation.

C. Makes eye contact with the nurse: Eye contact demonstrates attention and willingness to engage with the nurse, which is a positive sign that the child is prepared to follow directions during data collection.

D. Allows the nurse to touch him on the arm: Tolerating touch shows trust and comfort with the nurse’s presence and interventions, signaling the child is ready to participate in the assessment.

E. Sits on his parent's lap when the nurse enters the room: Sitting on a parent’s lap may indicate the child is seeking comfort and security rather than being ready to cooperate independently. This behavior alone does not confirm readiness for assessment.