Certified Emergency Nurse (CEN) Practice Test

In the treatment of hypernatremia, addressing hypovolemia is typically the first priority. Hypernatremia often occurs due to a dehydration state, where there is a loss of free water leading to an elevated serum sodium concentration. Initially treating hypovolemia is crucial as it helps restore the intravascular volume and ensures adequate renal perfusion, which is vital for the kidneys to help in the proper excretion of excess sodium.

By correcting hypovolemia through the appropriate administration of fluids, such as isotonic solutions, the body can begin to equilibrate. Following the correction of hypovolemia, other aspects of hypernatremia management can be addressed, such as gradual reduction of serum sodium levels through controlled fluid replacement or other treatments. This step-wise approach ensures that the patient's safety is prioritized while avoiding rapid shifts in sodium levels, which can lead to complications like cerebral edema.

The other choices do not align with the immediate management priorities in hypernatremia. Increasing sodium levels would exacerbate the condition, limiting fluid intake would worsen the existing hypovolemic state, and administering potassium is not relevant unless there is a specific indication for potassium management. Therefore, addressing hypovolemia effectively sets the stage for further treatment