Registered dietitian question MNT clinical

Question

patient admitted:

80 kg

Usual body weight 77 (

Na: 129

Osm 268 L

urine sodium normal

which is true?

1. patient has renal failure

2. The patient is in cardiac failure

3. The patient should restrict free water and sodium

4. both 2,3

Answer 1

The most correct answer is 3.

This patient is experiencing hypervolemic hypotonic hyponatremia, so free water and sodium restrictions are indicated.

Unfortunately, Urinary Sodium is "normal" which does not help differentiate whether this pt is in cardiac or renal failure. In practice, we will probably be able to do see a BMP to look at BUN/Cr (Renal failure), a bedside exam to see if the patient has edema and other symptoms of heart failure. But since this is a multiple-choice no3 is the best option.