Answer :
Final answer:
The nurse should immediately report the serum sodium level of 118 mEq/L to the healthcare provider. This value is significantly below the normal range, indicating a condition known as hyponatremia, which can result in serious neurological symptoms.
Explanation:
The finding that the nurse should report immediately to their health care provider is the serum sodium level of 118 mEq/L. This level is significantly lower than the normal range (135-145 mEq/L), indicating a condition known as hyponatremia. Hyponatremia, especially at acute onset, can lead to severe neurological symptoms, which may explain the confusion reported in the patient. It is a critical electrolyte disturbance that requires prompt attention and management.
Oliguria, or a decreased urine output, and a weight gain could be signs of fluid retention possibly due to kidney issues. A specific gravity of 1.004, while on the lower end, is still within normal range (1.002-1.030), indicating diluted urine which could be due to increased fluid intake or certain kidney conditions. It's not as immediately concerning as the serum sodium level. Nausea and vomiting are non-specific symptoms and while they might indicate an underlying problem, without additional information they aren't immediately critical.
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