Final answer:
The assessment finding indicating hypertonic dehydration is a high urine specific gravity of 1.045. This condition reflects a high serum sodium concentration, causing water to shift out of cells, resulting in cellular dehydration and possible neurological disturbances.
Step-by-step explanation:
The assessment finding that should cause the nurse to suspect that the patient has hypertonic dehydration is D. Urine specific gravity is 1.045. Hypertonic dehydration, also known as hypernatremic dehydration, occurs when there is a loss of water more than the loss of electrolytes, leading to a high concentration of serum sodium and therefore a high urine specific gravity. This condition can result in serious complications such as intracellular dehydration, leading to cell dysfunction and damage.
Hypertonic dehydration is indicated by an increased serum sodium level and a urine specific gravity that is higher than normal (normal range is 1.010 to 1.025). In hypertonic dehydration, symptoms may include increased thirst, confusion, and in severe cases, neurological disturbances due to cellular dehydration, including within the brain. The primary management of hypertonic dehydration is carefully calculated rehydration, taking care to correct the fluid deficit without causing rapid shifts in electrolyte balance that could lead to cerebral edema.