A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment data will require the most rapid response by the nurse?
a. The patient's radial pulse is 105 beats/minute.
b. There is sediment and blood in the patient's urine.
c. The blood pressure increases from 120/80 to 142/94.
d. There are crackles audible throughout both lung fields.
ANS: D
Crackles throughout both lungs suggest that the patient may be experiencing pulmonary edema, a life-threatening adverse effect of hypertonic solutions. The increased pulse rate and blood pressure and the appearance of the urine also should be reported, but they are not as dangerous as the presence of fluid in the alveoli.
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