The nurse is caring for a patient in DKA with serum sodium of 130 and serum glucose of 600. After calculating the corrected serum sodium (CSS) [CSS = Serum Na⁺ + {[(Serum glucose (mg/dL) - 100) / 100] × 1.6}], which intravenous fluid should the nurse plan to provide this patient?

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1. CSS = 130 + {[(600 - 100) / 100] × 1.6}; CSS = 138. Normal serum sodium is
135−145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
2. CSS = 130 + {[(600 - 100) / 100] × 1.6}; CSS = 138. Normal serum sodium is
135−145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
3. CSS = 130 + {[(600 - 100) / 100] × 1.6}; CSS = 138. Normal serum sodium is
135−145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.
4. CSS = 130 + {[(600 - 100) / 100] × 1.6}; CSS = 138. Normal serum sodium is
135−145 mEq/L. If the CSS is high or normal, then half-normal saline (0.45% NS) would be expected. If the CSS is low, then normal saline (0.9% NS) would be expected to correct sodium losses.

The Nurse Is Caring for a Patient in DKA with Serum