Question

All of the following statements concerning severe hyperglycemia's effect on serum Na+ levels are true, EXCEPT

A) as insulin is administered, serum Na+ levels will return to normal.

B) administering a hypertonic saline would help compensate for the decreased Na+ levels.

C) levels are measured as a concentration, so as water decreases, levels increase.

D) the amount of Na+ is really unchanged since the water has only changed location and not left the body.

E) the Na+ levels would appear decreased as the ICF water leaves for the hyperosmotic ECF

Answer 1

The incorrect statement is B) administering a hypertonic saline would help compensate for the decreased Na+ levels, as it can exacerbate hyperosmolarity in hyperglycemic conditions. Insulin therapy would help normalize serum Na+ as the water balance is corrected.

Step-by-step explanation:

The statement regarding severe hyperglycemia's effect on serum Na+ levels that is NOT true is: B) administering a hypertonic saline would help compensate for the decreased Na+ levels. This is incorrect because in the context of hyperglycemia, where there's already a hyperosmolar state (high solute concentration in the blood), adding more solutes with a hypertonic saline solution could exacerbate the osmolarity, potentially leading to worse outcomes.

Usually, hyperglycemia leads to hypernatremia (increased blood sodium levels), because the high glucose levels act as effective osmoles pulling water out of cells and into the extracellular fluid (ECF), effectively diluting the sodium in the ECF. This can be misinterpreted as hyponatremia (decreased blood sodium levels) because the amount of Na+ is really unchanged; it's the water distribution that's affected. With insulin therapy, water re-enters cells, serum Na+ concentration should normalize as glucose is removed and osmolarity decreases, accounting for statement A).