Major electrolyte imbalance that occurs in water intoxication is

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Water intoxication (hyperhydration) involves consuming excessive water faster than the kidneys can excrete it.
This excess free water dilutes the sodium in the extracellular fluid, decreasing its concentration.
A serum sodium level below 135 mEq/L is defined as hyponatremia.
This resulting hypotonic state causes an osmotic shift of water into brain cells, leading to cerebral edema and neurological symptoms.

Option A: Hypernatremia is an elevated sodium level, the opposite of what occurs in water intoxication. It is caused by a deficit of total body water relative to total body sodium.
Option C: Hypokalemia is a low potassium level. While severe fluid and electrolyte shifts can influence potassium, it is not the primary or defining imbalance of water intoxication.
Option D: Hyperkalemia is a high potassium level. This condition is unrelated to excessive water intake and is most often associated with the body's inability to excrete potassium.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of water intoxication and resulting electrolyte imbalance as background academic context rather than a clinical decision trigger.
Nurses must monitor for early signs of hyponatremia, such as headache, confusion, nausea, and muscle cramps, especially in at-risk patients (e.g., those with psychogenic polydipsia, athletes, or receiving hypotonic IV fluids).
Key nursing interventions for hyponatremia include implementing fluid restrictions, closely monitoring serum sodium levels and neurological status, and administering prescribed hypertonic saline in severe, symptomatic cases.
Patient education is crucial, particularly for athletes, on the importance of replacing electrolytes along with water during intense exercise to prevent dilutional hyponatremia.

How to Approach the Question

First, identify the key term in the question: 'water intoxication'.
Understand the pathophysiology of this condition: 'intoxication' with 'water' means there is too much water in the body.
Consider the effect of adding a large volume of a solvent (water) to a solution (the blood/extracellular fluid). This action causes dilution.
Recall that sodium is the primary electrolyte in the extracellular fluid. Therefore, diluting the ECF will lower the sodium concentration.
Match this physiological effect ('low sodium') with the correct medical term from the options provided. 'Hypo-' means low, and 'natremia' refers to sodium.
Select 'Hyponatremia' as the direct consequence of water intoxication.

Concept Tested & Keywords

Concept Tested: Pathophysiology of water intoxication and resulting electrolyte imbalance.
Stem keywords: water intoxication, electrolyte imbalance
Lead-in keywords: Major

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