A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?

Hyperkalemia

Hypokalemia

Hyponatremia

Hypercalcemia

Answer and Explanation

The Correct Answer is C

Choice A reason: Hyperkalemia, or elevated potassium levels in the blood, is not typically seen in patients with SIADH. SIADH is primarily characterized by water retention and the resultant dilution of electrolytes, most notably sodium. Potassium levels are not directly affected by the antidiuretic hormone (ADH) abnormalities present in SIADH, and thus hyperkalemia is not an expected finding.

Choice B reason: Hypokalemia, which refers to low potassium levels in the blood, is also not a characteristic feature of SIADH. While potassium imbalances can occur due to a variety of conditions and medications, they are not the hallmark of SIADH. The syndrome's primary effect on electrolyte balance involves sodium, not potassium.

Choice C reason: Hyponatremia, or low sodium levels in the blood, is the defining feature of SIADH. In this condition, excessive secretion of antidiuretic hormone (ADH) leads to increased water reabsorption in the kidneys. This excess water dilutes the sodium in the bloodstream, leading to hyponatremia. The resulting imbalance can cause symptoms ranging from mild (such as headache and nausea) to severe (such as seizures and altered mental status), depending on the degree of sodium depletion.

Choice D reason: Hypercalcemia, or high calcium levels in the blood, is not associated with SIADH. The condition of SIADH affects water and sodium balance due to inappropriate ADH secretion but does not typically influence calcium levels. Hypercalcemia can be seen in other conditions, such as hyperparathyroidism or malignancies, but it is not related to the pathophysiology of SIADH.

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Correct Answer is D

Explanation

Choice A reason: Preventing constipation is not the primary reason for prescribing metoprolol alongside nifedipine. While managing side effects is important in patient care, metoprolol does not have a notable effect on gastrointestinal motility to address constipation.

Choice B reason: Reducing flushing is not the main purpose of metoprolol. Flushing can sometimes be a side effect of vasodilatory medications, but it is not the specific reason for adding a beta-blocker like metoprolol to a treatment regimen involving a calcium channel blocker like nifedipine.

Choice C reason: Minimizing gingival hyperplasia is not the intended effect of metoprolol. Gingival hyperplasia can be a side effect of certain medications, such as calcium channel blockers like nifedipine, but metoprolol does not specifically counteract this effect.

Choice D reason: Preventing reflex tachycardia is the primary reason for prescribing metoprolol alongside nifedipine. Nifedipine, a calcium channel blocker, can cause vasodilation, which may lead to a reflex increase in heart rate (tachycardia) as the body tries to maintain blood pressure. Metoprolol, a beta-blocker, helps prevent this reflex tachycardia by slowing the heart rate and reducing the workload on the heart, thus complementing the antihypertensive effect of nifedipine.

A. Hypernatremia B. Hypokalemia C. Hypertension D. Hyperkalemia

Correct Answer is D

Explanation

Choice A reason: Hypernatremia (high sodium levels) is not typically associated with ACE inhibitors like enalapril. These medications do not significantly affect sodium levels in the body.

Choice B reason: Hypokalemia (low potassium levels) is not a common concern with ACE inhibitors. In fact, these medications can sometimes cause the opposite effect, leading to higher potassium levels.

Choice C reason: Hypertension (high blood pressure) is the condition that ACE inhibitors like enalapril are prescribed to treat. While monitoring blood pressure is important, it is not the specific concern related to potassium levels.

Choice D reason: Hyperkalemia (high potassium levels) is a significant concern for patients taking ACE inhibitors like enalapril. These medications can increase potassium levels in the blood, which can lead to serious complications such as cardiac arrhythmias. Therefore, patients need to be monitored carefully for signs of hyperkalemia, and their potassium levels should be checked regularly.

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A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?

Nursing Test Bank

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