Nursing interventions for a patient with hyponatremia include:
A. Administering hypotonic IV fluids.
B. Encouraging water intake.
C. Restricting fluid intake.
D. Restricting sodium intake.
Correct Answer: C. Restricting fluid intake
Hyponatremia involves a decreased concentration of sodium in relation to fluid volume, so restricting fluid intake is indicated. In the presence of fluid excess or SIADH, fluid restriction is indicated while in the presence of hypovolemia, volume losses are replaced with isotonic saline, or, on occasion, hypertonic solution when hyponatremia is life-threatening.
Option A: Administer sodium chloride as indicated. Used to replace deficits in the presence of chronic or ongoing losses. Identify the client at risk for hyponatremia and the specific cause such as sodium loss or fluid excess. Provides clues for early intervention. Hyponatremia is a common imbalance, especially in the elderly, and may range from mild to severe.
Option B: Provide or restrict fluids, depending on fluid volume status. Encourage fluids and foods high in sodium such as meat, milk, beets, celery, eggs, and carrots. Use fruit juices and bouillon instead of water. Unless sodium deficit causes serious symptoms requiring immediate IV replacement, the client may benefit from slower replacement by oral method or removal of previous salt restriction.
Option D: Monitor intake and output; Calculate fluid balance. Weigh the client daily. Fluid balance indicators are important since either fluid excess or deficit may occur with hyponatremia.
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