A client with liver failure has a serum sodium level of 160 mEq/L. With just the information provided, what intervention would the nurse anticipate to implement?

A. Administer 3% NS: Hypertonic saline (3% NaCl) is used in cases of severe hyponatremia to raise serum sodium levels. The sodium level is already markedly elevated at 160 mEq/L, indicating hypernatremia. Administering hypertonic saline would further increase serum sodium concentration, worsening cellular dehydration and increasing risk of neurologic complications. B. Administer Lactated Ringers @ 100 mL/hr: Lactated Ringer’s solution is an isotonic crystalloid with a lower sodium concentration (~130 mEq/L) compared to normal saline. In hypernatremia, fluid therapy aims to gradually lower serum sodium and restore intracellular hydration. Lactated Ringer’s can help dilute serum sodium and support volume status. C. Administer 0.9% NS @ 100 mL/hr: Normal saline contains 154 mEq/L of sodium, which is close to or higher than the client’s already elevated sodium level. Administering it may fail to correct hypernatremia and can potentially worsen it, particularly if free water deficit is the underlying issue. It is not the preferred fluid for lowering serum sodium. D. Document findings in client chart: While documentation is essential, a sodium level of 160 mEq/L represents severe hypernatremia and requires prompt intervention. Delaying treatment by only documenting the finding without initiating or anticipating corrective measures can lead to worsening neurologic impairment due to cellular dehydration.