Hypernatremia | Fluid and Electrolytes NCLEX & Nursing School Exams Like A Boss

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Hypernatremia – Notes

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HYPERNATREMIA NCLEX QUIZ QUESTIONS

Question 1: A nurse receives report on a patient who has overdosed on aspirin. The patient presentation includes thready, weak, rapid pulse rate; hypotension; flat neck veins; normal central venous pressure. What does the nurse believe the diagnosis is?

1. Hypervolemic Hypernatremia
2. Hypovolemic Hypernatremia
3. Hypervolemic Hyponatremia
4. Hypovolemic Hyponatremia

 

Question 2: A patient has developed hypernatremia after administration of TPN. What might the nurse find when assessing his or her patient? SELECT ALL THAT APPLY

1. Vomiting
2. Bloating
3. Dry Skin
4. Decreased urine output
5. Muscle twitching

 

Question 3: A patient as arrived to the emergency department via EMS for evaluation. The patient presents with muscle twitching, hypotension, and decreased urine output. The serum sodium level is 150 mEq/L. What interventions should the nurse expect the perform? SELECT ALL THAT APPLY

1. Perform frequent neurological assessments
2. Limit oral intake of sodium
3. Sodium wasting diuretics
4. Bring Sodium down slowly
5. Increase Fluid Intake
6. Administer 3% Normal Saline

 

Question 4: What fluid orders would a nurse expect to administer for a hypernatremic patient?

1. IV Insulin administration
2. 3% Normal Saline
3. 45% NS
4. 9% Normal Saline

 

Question 5: A nurse is receiving report for a hypernatremic with mild symptoms. What would the nurse expect to find if the hypernatremic symptoms have progressed to the moderate stage?

1. Faint feeling, muscle fatigue, weakness
2. Nausea, vomiting, seizures, coma
3. Muscle twitching, weakness, increased muscle tone
4. Confusion, dry red tongue, muscle twitching, thirst

HYPERNATREMIA NCLEX QUIZ ANSWERS

Question 1: A nurse receives report on a patient who has overdosed on aspirin. The patient presentation includes thready, weak, rapid pulse rate; hypotension; flat neck veins; normal central venous pressure. What does the nurse believe the diagnosis is?

1. Hypervolemic Hypernatremia
2. Hypovolemic Hypernatremia
3. Hypervolemic Hyponatremia
4. Hypovolemic Hyponatremia

Hypovolemic hypernatremia can exhibit thready, weak, rapid pulse rates; flat neck veins; normal or low central venous pressure. Hypervolemic hyponatremia can exhibit rapid, bounding pulse; blood pressure normal or elevated; normal or elevated central venous pressure.

 

Question 2: A patient has developed hypernatremia after administration of TPN. What might the nurse find when assessing his or her patient? SELECT ALL THAT APPLY

1. Vomiting
2. Bloating
3. Dry Skin
4. Decreased urine output
5. Muscle twitching

Bloating, dry skin, decreased urine output, and muscle twitching are all signs of hypernatremia.

 

Question 3: A patient as arrived to the emergency department via EMS for evaluation. The patient presents with muscle twitching, hypotension, and decreased urine output. The serum sodium level is 150 mEq/L. What interventions should the nurse expect the perform? SELECT ALL THAT APPLY

1. Perform frequent neurological assessments
2. Limit oral intake of sodium
3. Sodium wasting diuretics
4. Bring Sodium down slowly
5. Increase Fluid Intake
6. Administer 3% Normal Saline

Neurological assessments should be performed frequently for signs and symptoms of mental status changes, muscle twitching, and decreased deep tendon reflexes. Limiting oral sodium and increase fluid intake will help prevent the hypernatremia from worsening. Hypotonic IV solutions can help increase fluid volume without providing sodium like in hypertonic solutions. Rapid correction can lead to seizures due to the rapid fluid shifts in the brain. 3% Normal Saline is a hypertonic solutions and can further worsen hypernatremia.

 

Question 4: What fluid orders would a nurse expect to administer for a hypernatremic patient?

1. IV Insulin administration
2. 3% Normal Saline
3. 0.45% NS
4. 0.9% Normal Saline

0.45% NS is a hypotonic solution and can be used to hypernatremic patients. Hypotonic Solutions cause fluid shifts from the extravascular space to the intracellular space to help correct elevated serum sodium levels.

 

Question 5: A nurse is receiving report for a hypernatremic with mild symptoms. What would the nurse expect to find if the hypernatremic symptoms have progressed to the moderate stage?

1. Faint feeling, muscle fatigue, weakness
2. Nausea, vomiting, seizures, coma
3. Muscle twitching, weakness, increased muscle tone
4. Confusion, dry red tongue, muscle twitching, thirst

Confusion, dry red tongue, hyperreflexia, edema, and thirst are all moderate symptoms of hypernatremia.