A nurse is caring for a client with hypernatremia. Which of the following actions should the nurse take?

• Choice A reason:

• Administering calcium supplements orally or IV is not an appropriate intervention for a client with hypocalcemia. Calcium supplements can cause hypercalcemia, which can lead to cardiac arrhythmias, kidney stones, and constipation. Calcium supplements should only be given if the hypocalcemia is severe or symptomatic and under the supervision of a physician.

• Choice B reason:

• Monitoring the client for signs of tetany and seizures is an appropriate intervention for a client with hypocalcemia. Hypocalcemia can cause increased neuromuscular excitability, which can manifest as muscle spasms, cramps, twitching, or convulsions. Tetany is a condition where the muscles contract involuntarily and can affect the hands, feet, face, or larynx. Seizures are a result of abnormal electrical activity in the brain that can be triggered by low calcium levels. The nurse should monitor the client for these signs and intervene promptly to prevent complications.

• Choice C reason:

• Providing a high-phosphorus diet is not an appropriate intervention for a client with hypocalcemia. Phosphorus and calcium have an inverse relationship in the body, meaning that when one is high, the other is low. A high-phosphorus diet can lower the serum calcium level further and worsen the hypocalcemia. The nurse should advise the client to avoid foods high in phosphorus, such as dairy products, meat, poultry, fish, eggs, nuts, seeds, beans, and cola drinks.

• Choice D reason:

• Avoiding stimulating the facial nerve is not an appropriate intervention for a client with hypocalcemia. Stimulating the facial nerve can elicit a positive Chvostek's sign, which is a facial twitching that occurs when the nerve is tapped near the ear. A positive Chvostek's sign indicates hypocalcemia and increased neuromuscular irritability. However, avoiding stimulating the facial nerve does not prevent or treat hypocalcemia. The nurse should monitor the client for other signs of hypocalcemia and administer calcium as prescribed.

Choice A reason:

A headache that won't go away is a possible complication of hyponatremia, which is a low level of sodium in the blood. Hyponatremia can cause brain swelling, which can lead to headaches, confusion, seizures, and coma.

Choice B reason:

Feeling very thirsty all the time is not a complication of hyponatremia, but rather a symptom of diabetes insipidus, which is a condition that causes the body to produce large amounts of dilute urine and lose water. Diabetes insipidus occurs when there is a deficiency of antidiuretic hormone (ADH), which is the opposite of SIADH.

Choice C reason:

Having trouble sleeping at night is not a complication of hyponatremia, but rather a common problem that can have many causes, such as stress, anxiety, caffeine, noise, or medication. Having trouble sleeping at night is not directly related to SIADH or sodium levels.

Choice D reason:

Losing weight recently is not a complication of hyponatremia, but rather a possible sign of fluid loss or dehydration. Fluid loss can occur in conditions that cause excessive urination, such as diabetes insipidus or diuretic use. Fluid loss can also cause hyponatremia, but it is not caused by SIADH.