A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by the nurse?Reference Range Sodium (136 to 145 mEq/L)
Explanation & Rationale
Choice A reason:The correct answer is a) because a serum sodium level of 185 mEq/L is significantly higher than the normal range (136 to 145 mEq/L) and indicates severe hypernatremia, which requires immediate intervention to prevent complications such as neurological damage.Choice B reason: Polyuria and excessive thirst are common symptoms of diabetes insipidus and require attention but are not as immediately critical as severe hypernatremia.Choice C reason: Dry skin with inelastic turgor indicates dehydration, which is a concern, but immediate intervention is more critical for a significantly elevated serum sodium level.Choice D reason: An apical heart rate of 110 beats per minute is elevated but does not require as immediate intervention as severe hypernatremia.