15. A client with diabetes has a blood sugar of 300 mg/dL and an Na+ of 133. What nursing intervention is indicated to manage the sodium with this client?
15. A client with diabetes has a blood sugar of 300 mg/dL and an Na+ of 133. What nursing intervention is indicated to manage the sodium with this client?
. Pad the side rails to protect from injury during a possible seizure.
. Notify dietary department to send salt tablets.
. Encourage the client to drink water.
. Monitor Na+ return to normal with lowering of blood sugar.
Test-Taking Tip
Ask: Is there a problem or not at this time? Understand the physiologic changes when blood sugar is lowered. The low sodium is occurring because of hemodilution. Select the answer that "monitors," rather than an action (pads, salt tablets, or water).
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Fluid and Electrolyte Imbalances
.
Answer 1 is incorrect because seizures can result from very low blood sugar or Na+, but these values are not low enough to be associated with seizure risk. Answer 2 is incorrect because this Na+ level is only mildly low and does not require treatment with sodium. Answer 3 is incorrect because ingestion of free water would further dilute the sodium. Answer 4 is correct because, as blood sugar rises, serum osmolarity increases and the pituitary secretes antidiuretic hormone. This causes the kidneys to retain free water, diluting down serum sodium. Direct treatment of the hyponatremia is not needed.