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use RISE module to respond to this discussion in no more than 250 words During my practicum, I cared for a middle-aged male patient admitted with altered mental status, dry mucous membranes, and orthostatic hypotension. His serum sodium was 154 mEq/L, indicating hypernatremia. The patient had a history of dementia and lived in a group home, where inadequate access to fluids during a heatwave likely contributed to dehydration. This case exemplified the importance of identifying and safely correcting sodium imbalances. Assessment: For both hypernatremia and hyponatremia, the initial assessment began with a focused history and physical exam. In this case, clues such as impaired thirst response, poor fluid intake, and environmental exposure raised suspicion for hypernatremia. We evaluated his volume status by assessing orthostatic changes, skin turgor, mucous membranes, and daily weight. Lab work included serum sodium, osmolality, BUN, and creatinine. A high serum osmolality confirmed true hypernatremia, while elevated BUN and creatinine suggested hypovolemia. In prior cases of hyponatremia, I assessed for symptoms like nausea, fatigue, gait disturbance, and confusion. Laboratory tests such as serum osmolality and urine sodium and osmolality were used to differentiate between hypovolemic, euvolemic, and hypervolemic hyponatremia (Sterns et al., 2024). Urine sodium <20 mEq/L often indicates hypovolemia; high urine sodium and osmolality suggest SIADH. Management: For hypernatr
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