Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is the ideal treatment for a low serum sodium level?

1. Slow normalization with 3% saline and Lasix

2. Immediate administration of isotonic fluids

3. Rapid infusion of hypertonic saline

4. Dietary sodium restriction

The correct answer is: Slow normalization with 3% saline and Lasix

The ideal treatment for a low serum sodium level, particularly in cases of hyponatremia, involves slow normalization to prevent complications such as osmotic demyelination syndrome. Using 3% saline provides a hypertonic solution that can effectively raise serum sodium levels gradually. This approach allows for careful monitoring and adjustment of the sodium concentration to avoid causing further neurological damage. Incorporating Lasix (furosemide) assists in preventing fluid overload and managing the fluid status of the patient, especially if there is concurrent fluid retention. The combination ensures that sodium levels are corrected in a controlled manner, following established protocols for safe and effective management of hyponatremia. Other treatment options, such as immediate isotonic fluid administration or rapid infusion of hypertonic saline, can pose risks of rapid sodium rises, increasing the likelihood of severe neurological side effects. On the other hand, dietary sodium restriction is not a treatment for low serum sodium levels; rather, it is contraindicated as it would exacerbate the condition. Therefore, the careful administration of 3% saline, potentially with diuretics, presents the most appropriate and safest strategy for treatment in this situation.