An obtunded 84-year-old man is admitted to the hospital from the nursing home with a high fever. The following

clinical data are obtained on admission: temperature 39.4°C

(102°F); BP 150/90; pulse rate of 110; dry, mucous membranes. Laboratory test results include the following: serum

Na+ = 184 mEq/L, urine osmolality = 640 mOsm/kg; urine

culture and sensitivity shows pyuria and many bacteria. His

peripheral IV at the site of the right dorsal metacarpal vein is

infiltrated. What method of administering IV fluids would

the nurse anticipate? What factors are probably contributing

to his hypernatremia? What nursing actions should be taken

in assisting with treatment of this patient’s fluid and electrolyte imbalance?

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