The nurse is caring for a patient who has had severe vomiting. The patient's serum sodium level is 130 mEq/L. The nurse will expect the patient's provider to order which treatment?
a. Diuretic therapy
b. Intravenous hypertonic 5% saline
c. Intravenous normal saline 0.9%
d. Oral sodium supplements
ANS: C
Patients with hyponatremia may be treated with oral sodium supplements if the patient is able or if the deficit is mild. This patient is vomiting and would not be able to take supplements easily. For a serum level between 125 and 135 mEq/L, normal saline may increase sodium content in vascular fluid. Hypertonic saline is used for severe hyponatremia with a serum sodium <120 mEq/L. Diuretics would further deplete sodium and fluid volume in a patient already likely to be dehydrated from severe vomiting.
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