A patient's serum sodium level upon admission was 148 mEq/L, her heart rate was 110 lying supine, and her blood pressure was 88/60. What is the most appropriate fluid therapy?

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Quizplus · Accepted Answer

The patient's high serum sodium level indicates hypernatremia, which can be caused by insufficient water intake or excessive water loss. The low blood pressure and tachycardia suggest hypovolemia. Therefore, the most appropriate fluid therapy would be administering IV normal saline (0.9%), which will increase intravascular volume and correct the electrolyte imbalance. Pushing oral fluids may not be sufficient to rapidly correct the hypovolemia and hypernatremia. Free water restriction may exacerbate hypovolemia and cause further electrolyte imbalances. Administering IV 5% dextrose in water may be appropriate in some cases, but not in this situation as it does not address the hypovolemia and hypernatremia.

A Patient's Serum Sodium Level Upon Admission Was 148 MEq/L