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 C

Explanation

a. Weight gain: Hyperthyroidism is more commonly associated with weight loss due to increased metabolism.

b. Constipation: Hyperthyroidism is more likely to cause diarrhea or increased bowel movements.

c. Frequent mood changes: Hyperthyroidism can lead to mood swings, irritability, and anxiety.

d. Sensitivity to cold: Sensitivity to cold is more commonly associated with hypothyroidism, not hyperthyroidism.

A. Instruct the client to tilt her head back when she swallows. B. Add thickener to fluids. C. Place food on the left side of the client's mouth. D. Serve food at room temperature.

Correct Answer is B

Explanation

a. Instruct the client to tilt her head back when she swallows: This action is not recommended, as it increases the risk of aspiration. Tilted head positions can lead to improper bolus control and

swallowing difficulties.

b. Add thickener to fluids: This is an appropriate intervention for a client with dysphagia, as thickened fluids are easier to control during swallowing and reduce the risk of aspiration.

c. Place food on the left side of the client's mouth: This action may not directly address the risk of aspiration associated with dysphagia and left-sided weakness.

d. Serve food at room temperature: While serving food at room temperature may be preferred for some clients, it does not directly address the safety concerns associated with dysphagia and left- sided weakness.

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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?

Nursing Test Bank

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