A nurse is assisting in the plan of care for a client who had a removal of the pituitary gland. Which of the following actions should the nurse include in the plan?

Choice A reason: Osteoarthritis is a degenerative joint disease and is not associated with SIADH. It does not typically affect the body's regulation of antidiuretic hormone (ADH) or fluid balance.

Choice B reason: Lung cancer, particularly small cell lung cancer, is a common cause of SIADH. Tumor cells can produce and secrete ADH, leading to inappropriate water retention and hyponatremia. Therefore, asking about lung cancer history is important in the assessment.

Choice C reason: The correct answer is c because liver cirrhosis can lead to secondary conditions that may affect fluid balance and ADH secretion. Although not a direct cause of SIADH, liver dysfunction can complicate the clinical picture and contribute to fluid retention issues.

Choice D reason: Dyspepsia, or indigestion, is not related to SIADH and does not typically impact ADH regulation. It is a gastrointestinal issue that does not affect fluid balance.

Choice E reason: The correct answer is e because seizures can be associated with conditions that trigger SIADH. Neurological disorders, including brain injuries and infections, can lead to the inappropriate release of ADH, resulting in fluid retention and hyponatremia.

Choice A reason: Massaging erythematous bony prominences can actually cause further damage to the skin and underlying tissues. It is better to relieve pressure and monitor the skin closely for any signs of breakdown.

Choice B reason: Implementing a turning schedule every 4 hours is not frequent enough. Clients with spinal cord injuries should be repositioned every 2 hours to prevent prolonged pressure on any one area and reduce the risk of skin breakdown.

Choice C reason: The correct answer is c because using pillows to keep the heels off the bed surface helps prevent pressure ulcers on the heels, which are common sites of skin breakdown in immobilized clients. This technique helps distribute pressure more evenly and reduces the risk of ulcers.

Choice D reason: Keeping environmental humidity less than 30% is not recommended, as low humidity can lead to dry and cracked skin, increasing the risk of skin breakdown. Maintaining a moderate humidity level helps keep the skin hydrated and intact.

Choice E reason: The correct answer is e because minimizing skin exposure to moisture, such as sweat, urine, or wound exudate, helps prevent maceration and skin breakdown. Using moisture-wicking materials and keeping the skin dry and clean are important measures in skin care for paralyzed clients.