Final answer:
A nurse should anticipate modifying the sodium content in the TPN solution for a client with paralytic ileus and hypernatremia. A 5% dextrose infusion may also be considered to dilute the high sodium concentration. Furosemide and encouraging oral intake of water are not suitable interventions in this case.
Step-by-step explanation:
The student has inquired about the treatment a nurse should anticipate for a client with paralytic ileus who has developed hypernatremia while on total parenteral nutrition (TPN). Hypernatremia, a higher-than-normal concentration of sodium in the blood, can be a symptom of dehydration and confusion in patients.
To correct hypernatremia, modifications in the sodium content of the TPN solution would likely be one of the steps taken. However, this would not offer immediate correction of the sodium imbalance. Thus, initiating a 5% dextrose infusion could be considered. This particular infusion is hypotonic compared to the blood and would help to dilute the sodium concentration. Neither encouraging oral intake of plain water nor giving a furosemide injection would be appropriate in this case. Furosemide is a diuretic that promotes sodium and water excretion, which would not be helpful in managing hypernatremia. Adjusting the patient's sodium intake through modification of the TPN infusion would address the underlying cause of the hypernatremia.