Reference no: EM133697903

In this scenario, my patient has their 3% NaCl continuous intravenous fluid running at double the rate it should be. The standard choice for continuous fluid is 0.9% NaCl as it is isotonic and shares the same osmolarity and electrolyte composition as human blood (Brashers et al, 2018). However, 3% NaCl is a hypertonic solution which means that this solution is significantly higher in salinity than human blood. This higher concentration of sodium makes it more likely that a patient, who is receiving this infusion, could become hypernatremic. Hypernatremia is a condition characterized by elevated sodium levels of more than 145 mmol/L (Brashers et al, 2018). As a result of the increased rate and infusion solution type, we can infer that this patient has become hypernatremic. Manifestations of hypernatremia include: intense thirst; restlessness; agitation; muscles twitching; pulmonary and peripheral edema; decreased level of consciousness; postural hypotension; increased blood pressure; tachycardia; and seizures (Lewis et al, 2019). In a patient who had 3% NaCl running at double the rate it should be, I would expect to see thirst, restlessness and agitation, and a change in their level of consciousness but I would assess for all manifestations through vital signs and a thorough head-to-toe assessment. At the peripheral intravenous ("PIV") site, I would expect to see erythema, swelling, phlebitis, and hear reports of pain or "pressure" at or around the insertion site. Once I have finised my assessments, I would notify the medical team and most responsible provider to attend the patient and do their own assessments. We can make an educated guess that the medical team would order blood work, like electrolytes and an arterial blood gas ("ABG") to be drawn. On these lab results, I would expect to see a serum sodium level over 145 mmol/L, and abnormal values on the ABG as well. In conclusion, a patient who is running a high-risk intravenous solution should always be assessed for signs and symptoms of hypernatremia, and the rate of infusion should be accurately programmed and double checked frequently. Thorough assessments and quick interventions are the key to best outcomes for patients who are receiving this infusion. can you please reply to this discussion using peer review ?