A nurse is caring for a client who has developed Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) from cancer. Which of the following nursing interventions should be included in the client's plan of care? (Select all that apply.)
Give the client a low sodium diet.
Monitor for serum electrolyte imbalances.
Obtain daily weights.
Educate the client on techniques to cope with thirst.
Increase IV fluids.
Correct Answer : A,B,C,D
A. Give the client a low sodium diet: SIADH causes retention of water and dilutional hyponatremia. Therefore, restricting sodium intake can help prevent further fluid retention and worsening of hyponatremia.
B. Monitor for serum electrolyte imbalances: SIADH can lead to electrolyte imbalances, particularly hyponatremia. Monitoring electrolyte levels, especially sodium, is essential for early detection and intervention.
C. Obtain daily weights: Monitoring daily weights is crucial for assessing fluid balance and detecting changes in hydration status, which is essential in clients with SIADH.
D. Educate the client on techniques to cope with thirst: Clients with SIADH often experience excessive thirst due to the body's inability to excrete excess water. Educating the client on strategies to manage thirst, such as chewing gum or sucking on ice chips, can help improve comfort.
E. Increase IV fluids: This option is incorrect because SIADH is characterized by water retention, so increasing IV fluids would exacerbate the condition and worsen hyponatremia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administration of erythropoietin (Epoetin): In chronic renal disease, the kidneys may not produce enough erythropoietin, leading to anemia. Epoetin is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in these clients.
B. Transfusion of red blood cells (RBCs): While transfusion of RBCs may be necessary in severe cases of anemia or acute blood loss, it is not the first-line treatment for anemia related to chronic renal disease. Erythropoietin-stimulating agents are preferred to stimulate endogenous RBC production.
C. Weekly monitoring of complete blood count (CBC): Monitoring of CBC is important to assess the response to treatment and adjust therapy as needed but does not represent a specific treatment for anemia in chronic renal disease.
D. An order for iron replacement medication: Iron replacement may be indicated if iron deficiency is contributing to the anemia, but it is not the primary treatment for anemia in chronic renal disease. Erythropoietin-stimulating agents are typically used first to address the underlying cause of anemia.
Correct Answer is A
Explanation
A. Assess the insertion site: Assessing the insertion site for bleeding, hematoma, or signs of infection is the priority action because complications at the insertion site can occur post- procedure and require immediate attention.
B. Keep the client NPO for 4 hr: Keeping the client NPO is not typically necessary after a cardiac catheterization unless there are specific orders or complications.
C. Keep the affected leg slightly flexed: The affected leg should actually be kept straight to prevent bleeding from the insertion site.
D. Elevate the head of the bed 45°: The head of the bed should usually be kept flat or only slightly elevated to reduce the risk of bleeding from the femoral site.
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