Which of the following clients does the nurse evaluate to be at risk - ProProfs Discuss
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Which of the following clients does the nurse evaluate to be at risk for developing hypernatremia?
A. 50-year-old with pneumonia, diaphoresis, and high fevers
B. 62-year-old with congestive heart failure taking loop diuretics
C. 39-year-old with diarrhea and vomiting
D. 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone (SIADH)

Asked by Olivia, Last updated: Dec 18, 2019

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3 Answers

John Adney

John Adney

Answered Feb 07, 2017

[email protected], I think the saying is water follows salt. However, the excess sweating would cause extreme fluid loss and hence the body's sodium levels become more concentrated .
 

John Adney

Water follows Na+
 

John Smith

John Smith

Answered Sep 10, 2016

50-year-old with pneumonia, diaphoresis, and high fevers
Diaphoresis and a high fever can lead to free water loss through the skin, resulting in hypernatremia. Loop diuretics are more likely to result in a hypovolemic hyponatremia. Diarrhea and vomiting cause both sodium and water losses. Clients with syndrome of inappropriate antidiuretic hormone (SIADH) have hyponatremia, due to increased water reabsorption in the renal tubules.
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delilew

Ok...so the saying sodium follows water is incorrect? I mean sweating makes u lose water thru the skin, so why wouldnt we lose salt? So why doesnt sweating make ur sodium level fall..making it hyponatremia?

John Adney

An increased sodium concentration would cause water to move into the cell, but since sodium does not follow water out as you are sweating. electrolytes are lost through the skin as well while sweating, but majority of water, which is why you would have an increased sodium concentration in the system, thus causing hypernatremia.

lisacausey

"Vomiting and diarrhea cause both sodium and water loss," is the rationale for not selecting C) "vomiting and diarrhea," as the cause of hypernatremia. However, vomiting and diarrhea ARE causes of hypernatremia, as mentioned in my lab textbook. The "water loss is greater than the Na+ loss."

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