Which of the following actions is inappropriate when implementing precautions in a client with hyponatremia?
Encouraging a low-sodium diet
Padding the side rails of the bed
Providing a quiet and calm environment
Having the client use the call light when toileting is needed
The Correct Answer is A
A. Encouraging a low-sodium diet is inappropriate for a client with hyponatremia. Hyponatremia is a condition of low sodium levels in the blood, and the priority in managing this condition is to restore normal sodium levels, not to restrict sodium.
B. Padding the side rails of the bed is appropriate to protect the client from injury, especially if the client is at risk for seizures due to the electrolyte imbalance.
C. Providing a quiet and calm environment is beneficial for a client with hyponatremia, as it can help reduce the risk of seizures or agitation associated with the condition.
D. Having the client use the call light when toileting is needed is a standard precaution to ensure the client’s safety, especially if they are at risk of falls or confusion due to the electrolyte imbalance.
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Related Questions
Correct Answer is B
Explanation
A. Advising the client to add citrus juices and bananas is inappropriate because these are high in potassium and would further increase the already elevated potassium level, potentially worsening hyperkalemia.
B. Obtaining a 12-lead ECG is the correct action. A potassium level of 6.8 mEq/L is critically high and can cause life-threatening cardiac arrhythmias. An ECG can help identify hyperkalemia-related changes, such as peaked T waves, widened QRS complexes, or arrhythmias.
C. While obtaining a serum sodium level might provide additional information, it does not address the immediate risk posed by the elevated potassium level. The priority is assessing the cardiac effects of hyperkalemia.
D. Suggesting that the client use a salt substitute is incorrect, as many salt substitutes contain potassium chloride, which could worsen hyperkalemia.
Correct Answer is B
Explanation
A. DSW (Dextrose in water) is not specifically used for compatibility with antibiotics. It is an intravenous fluid that provides water and glucose, but its use is not based on antibiotic compatibility.
B. DSW (5% dextrose in water) provides free water to the body. In the case of acute dehydration and hypernatremia, the water helps to dilute the high sodium levels in the bloodstream, lowering the sodium concentration.
C. DSW does not contain higher-than-normal amounts of sodium. It contains only a small amount of sodium from the dextrose, and its primary role is to provide free water.
D. DSW is not used to pull water out of the interstitial space. Hypertonic solutions (like 3% saline) are used for that purpose, not DSW.
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