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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