A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following actions should the nurse take?

Restrict oral fluids to 800 to 1,000 mL/day.

Maintain an IV of 0.45% sodium chloride.

Ensure the client receives a 2 g/day sodium diet.

Administer desmopressin acetate 0.2 mg orally.

Answer and Explanation

The Correct Answer is A

a. Restrict oral fluids to 800 to 1,000 mL/day: Hyponatremia is a characteristic finding in SIADH, and fluid restriction is a key intervention to correct the imbalance.

b. Maintain an IV of 0.45% sodium chloride: Infusing hypertonic (3%) saline may be indicated in severe cases of hyponatremia, but the initial step is fluid restriction.

c. Ensure the client receives a 2 g/day sodium diet: Dietary sodium restriction is not the primary intervention for SIADH. Fluid restriction is more critical.

d. Administer desmopressin acetate 0.2 mg orally: Desmopressin acetate is an antidiuretic

hormone and would exacerbate the retention of water, further decreasing sodium levels. It is not the appropriate intervention for this client.

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Correct Answer is B

Explanation

Rationale for A: Taking enteric-coated pills with meals is generally acceptable as food does not affect the integrity of the enteric coating. The coating is designed to withstand the acidic environment of the stomach and dissolve in the more neutral pH of the intestine.
Rationale for B: Enteric-coated tablets should not be crushed as this destroys the coating designed to protect the stomach lining from the medication's potentially irritating effects, ensuring the medication is released in the intestine.
Rationale for C: This statement is correct; enteric-coated medications are formulated to bypass the stomach and dissolve in the intestine, which can help minimize gastric side effects and irritation.
Rationale for D: It is common for anti-inflammatory medications like naproxen to take several weeks to reach full efficacy. This statement reflects a correct understanding of the medication's expected onset of action.

A. Maintain the client on bed rest. B. Strain the client's urine through a mesh filter. C. Encourage fluid intake of 1500 mL/day. D. Clamp the urinary catheter every 2 hr.

Correct Answer is B

Explanation

a. Maintain the client on bed rest: While rest may be indicated in some cases, it is not a specific intervention for managing renal stones with a urinary catheter.

b. Strain the client's urine through a mesh filter: Straining urine is essential to collect any stones that may have passed, allowing for analysis and identification.

c. Encourage fluid intake of 1500 mL/day: Adequate fluid intake is crucial to prevent stone formation, but the amount may vary depending on the client's specific needs and condition.

d. Clamp the urinary catheter every 2 hr: Clamping the urinary catheter is not a standard

intervention for managing renal stones. Straining the urine for stone collection is a more relevant intervention.

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A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following actions should the nurse take?

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