A client with a closed head injury demonstrates signs of syndrome of inappropriate antidiuretic hormone (SIADH). Which additional finding should the nurse expect to obtain?
Weight gain of 2 pounds (0.91 kg) in one day.
Fremitus over the chest wall.
Serum sodium of 150 mEq/L (150 mmol/L).
Urine specific gravity of 1.004.
The Correct Answer is A
Choice A reason: Weight gain of 2 pounds (0.91 kg) in one day is a sign of fluid retention, which occurs in SIADH due to excessive secretion of antidiuretic hormone (ADH). ADH causes the kidneys to reabsorb water and reduce urine output, leading to hyponatremia and hypervolemia.
Choice B reason: Fremitus over the chest wall is a sign of increased vibration or air movement in the lungs, which can indicate pneumonia, bronchitis, or pleural effusion. These are not related to SIADH, but may be complications of head injury or fluid overload.
Choice C reason: Serum sodium of 150 mEq/L (150 mmol/L) is a sign of hypernatremia, which is a high level of sodium in the blood. This is the opposite of what happens in SIADH, where sodium levels are low due to dilution by excess water.
Choice D reason: Urine specific gravity of 1.004 is a sign of diluted urine, which indicates low concentration of solutes in the urine. This is also the opposite of what happens in SIADH, where urine is concentrated and has a high specific gravity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Restriction of caloric intake is not a good change for a client with diabetes mellitus and an upper respiratory infection, because it can lead to hypoglycemia and malnutrition. The client needs adequate calories to maintain blood glucose levels and support immune function. Therefore, this choice is incorrect.
Choice B reason: Fewer fingerstick glucose checks are not a good change for a client with diabetes mellitus and an upper respiratory infection, because they can lead to poor blood glucose control and complications. The client needs frequent monitoring of blood glucose levels to adjust insulin doses and prevent hyperglycemia or hypoglycemia. Therefore, this choice is incorrect.
Choice C reason: Higher doses of insulin are a good change for a client with diabetes mellitus and an upper respiratory infection, because they can help lower blood glucose levels and prevent ketoacidosis. The client needs more insulin to overcome the increased insulin resistance caused by the infection and the stress hormones. Therefore, this choice is correct.
Choice D reason: Increased oral fluid intake is a good change for a client with diabetes mellitus and an upper respiratory infection, but it is not directly related to blood glucose management. The client needs more fluids to prevent dehydration and clear mucus from the respiratory tract. Therefore, this choice is not the best answer.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C","dropdown-group-3":"D","dropdown-group-4":"A"}
Explanation
The client has inhaled smoke, which can cause respiratory problemssuch as airway obstruction, bronchospasm, and pulmonary edema. The client also has initial fluid shifts, which can lead to electrolyte imbalancesuch as hyponatremia, hyperkalemia, and metabolic acidosis.
Choice A: inhaled smoke - respiratory problems
This is a correct choice. Inhaled smoke can damage the respiratory system by causing inflammation, edema, and carbon monoxide poisoning.
Choice B: initial fluid shifts - electrolyte imbalance
This is a correct choice. Initial fluid shifts occur when fluid moves from the intravascular space to the interstitial space due to increased capillary permeability. This can result in electrolyte imbalance such as low sodium, high potassium, and low bicarbonate levels.
Choice C: increased cardiac output - high blood sodium levels
This is an incorrect choice. Increased cardiac output is not a condition that occurs in burn patients. High blood sodium levels are not a common finding in burn patients either. High blood sodium levels can occur due to dehydration or excessive sodium intake.
Choice D: decreased catecholamines - hypometabolism
This is an incorrect choice. Decreased catecholamines are not a finding in burn patients. Catecholamines are hormones that increase heart rate, blood pressure, and metabolism in response to stress. Burn patients have increased catecholamines due to pain and tissue injury. Hypometabolism is also not a condition that occurs in burn patients. Hypometabolism is a state of low metabolic rate that can occur due to starvation, hypothyroidism, or hypothermia. Burn patients have increased metabolism due to increased energy demands for wound healing and thermoregulation.
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