A nurse is teaching a client with diabetes insipidus about the causes of hypernatremia. Which of the following statements by the client indicates a need for further teaching?

Choice A reason:

Administering hypertonic saline solution IV is not appropriate for a client with hypernatremia, because it will increase the serum sodium level and worsen the condition. Hypertonic saline is only used in severe cases of hyponatremia, when the serum sodium level is very low.

Choice B reason:

Encouraging the client to drink caffeinated beverages is not helpful for a client with hypernatremia, because caffeine can act as a diuretic and cause further fluid loss and dehydration. The client should be encouraged to drink water or hypotonic fluids to dilute the sodium concentration in the blood.

Choice C reason:

Monitoring the client's serum sodium level is the correct action for the nurse to take, because it will help to evaluate the effectiveness of the treatment and detect any changes in the client's condition. The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L) The nurse should monitor the client's serum sodium level frequently and report any abnormal values to the provider.

Choice D reason:

Increasing the client's sodium intake is contraindicated for a client with hypernatremia, because it will raise the serum sodium level and aggravate the symptoms. The client should avoid foods high in sodium, such as processed meats, cheese, canned soups, and salty snacks.

Choice A reason:

Avoiding foods that are high in protein is not necessary for a client with diabetes insipidus. Protein intake does not affect the serum sodium level or the urine output in this condition. Therefore, this statement does not indicate a need for further teaching.

Choice B reason:

Drinking water whenever thirsty is not adequate for a client with diabetes insipidus. This condition causes excessive urine output and dehydration, which can lead to hypernatremia (high sodium level in the blood) The client should drink fluids according to a prescribed schedule and monitor the urine specific gravity to prevent fluid imbalance. Therefore, this statement indicates a need for further teaching.

Choice C reason:

Taking the prescribed medication as directed is important for a client with diabetes insipidus. The medication is usually a synthetic form of antidiuretic hormone (ADH), which helps the kidneys retain water and reduce urine output. This can prevent dehydration and hypernatremia. Therefore, this statement does not indicate a need for further teaching.

Choice D reason:

Limiting the intake of salt and salty foods is advisable for a client with diabetes insipidus. Salt intake can increase the serum sodium level and worsen the fluid imbalance. The client should follow a low-sodium diet and avoid processed foods, canned foods, and table salt. Therefore, this statement does not indicate a need for further teaching.