RN Nursing · Liver Disorders · Practice question
A client with cirrhosis presents with a serum sodium level of 127 mEq/L. Which of the following interventions should the nurse prioritize in the client's care plan after discussion with the provider?
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✓
Hold diuretics to prevent further electrolyte imbalance.
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Increase fluid intake to help elevate sodium levels.
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Monitor albumin levels for nutritional status evaluation.
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Encourage foods high in potassium to balance electrolytes.
Answer & explanation
Correct: Hold diuretics to prevent further electrolyte imbalance.
A client with cirrhosis and a serum sodium of 127 mEq/L has dilutional hyponatremia, which is common in cirrhosis due to elevated antidiuretic hormone levels and portal hypertension causing fluid retention. The initial priority intervention is to hold diuretics, particularly loop diuretics and thiazides, because these agents promote further sodium and water loss, worsening the electrolyte imbalance. Diuretics may have been contributing to the hyponatremia and should be withheld after discussion with the provider. Increasing fluid intake would actually worsen dilutional hyponatremia by adding more free water, further diluting serum sodium — this is contraindicated. Standard management of dilutional hyponatremia in cirrhosis typically includes fluid restriction, not increased intake. Monitoring albumin levels is relevant to nutritional assessment in cirrhosis but does not directly address the acute hyponatremia and is not the priority intervention. Encouraging foods high in potassium does not correct sodium levels and, depending on renal function in cirrhosis, could risk hyperkalemia. Holding diuretics addresses the most likely correctable cause and prevents further deterioration of the sodium level, making it the priority action in this scenario.
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