CHAPTER 11 Fluids and Electrolytes^425
- Decreased level of consciousness due to decrease in neural activity with
hypervolemia - Muscle twitching due to irregular muscle contractions
- Muscle weakness bilaterally
- Blood pressure increased—compare with normal for patient
- Decreased myocardial contractility, resulting in less effective pumping action
of heart muscle - Distended neck veins in hypervolemic patients
- Less cardiac output, especially with hypovolemic patients
- Increased thirst in an attempt to increase fluid intake
INTERPRETING TEST RESULTS
- A blood serum sodium level > 145 mEq/L. Normal sodium is 135 to 145
mEq/L. - Spot urine for sodium level.
TREATMENT
Hypotonic IV fluids are typically given to correct hypernatremic patients who are
volume-depleted. Diuretics are also used to help correct the sodium balance.
- Administer 0.225 percent sodium chloride, 0.33 percent sodium chloride, or
0.45 percent sodium chloride to correct fluid and sodium status. - Administer diuretics to remove excess fluids and promote sodium loss:
- furosemide, bumetanide
NURSING DIAGNOSES
- Disturbed thought process
- Excess fluid volume
- Deficient fluid volume
NURSING INTERVENTION
- Monitor vital signs, check pulse rate and rhythm, check blood pressure, and
compare with prior.