ACTION STAT: Hypernatremia
Sarah Beth Given BSN, RN

October 2010 
Volume 40  Number 10
Pages 72 - 72
  PDF Version Available!

ACCOMPANIED BY HIS WIFE, Joseph Underhill, 84, arrives in your ED. His wife states that he's weak and confused. As you prepare to assess him, he develops seizure activity.You immediately assess and support his airway, breathing, and circulation. Establish seizure precautions and position him to prevent aspiration. You provide supplemental oxygen, and establish vascular access to administer antiepileptic drugs, as prescribed, while a colleague attaches him to a cardiac monitor and obtains vital signs. The antiepileptic drugs successfully stop Mr. Underhill's seizure activity.Mr. Underhill's temperature is 99° F (37.2° C) orally; heart rate and rhythm, sinus tachycardia at 124 beats/minute; SpO2, 98% with supplemental oxygen via 100% non-rebreather mask; respirations, 28; and BP, 100/60 mm Hg. His lungs are clear and his neck veins are flat. You note poor skin turgor and dry mucous membranes; his skin appears flushed. You obtain blood and urine specimens for

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