A nurse is preparing to administer medications to a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following medications should the nurse question?
Conivaptan hydrochloride 20 mg IV over 30 minutes STAT
Vasopressin 10 mcg PO daily
Sodium chloride tablets 1 g PO three times daily
Tolvaptan 30 mg PO twice daily
The Correct Answer is B
Choice A Reason:
Conivaptan hydrochloride is a vasopressin receptor antagonist used to treat hyponatremia associated with SIADH. It works by blocking the action of ADH, thereby promoting water excretion without losing sodium. This medication is appropriate for managing SIADH.
Choice B Reason:
Vasopressin, also known as antidiuretic hormone (ADH), is not appropriate for a patient with SIADH. SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Administering vasopressin would exacerbate the condition by increasing water retention and further lowering sodium levels.
Choice C Reason:
Sodium chloride tablets are used to manage hyponatremia by increasing sodium levels in the blood. This treatment is appropriate for patients with SIADH to help correct the sodium imbalance caused by excessive ADH.
Choice D Reason:
Tolvaptan is another vasopressin receptor antagonist that is used to treat hyponatremia associated with SIADH. It helps to increase serum sodium levels by promoting water excretion while retaining sodium. This medication is suitable for managing SIADH.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Injections in the thigh are absorbed more slowly compared to the abdomen. The thigh is a common site for insulin injections, but it does not provide the fastest absorption rate. The absorption rate can be influenced by physical activity, as exercise can increase blood flow to the muscles, potentially speeding up insulin absorption. However, under normal conditions, the thigh is not the fastest site for insulin absorption.
Choice B reason:
Injections in the upper arm have a moderate absorption rate. The upper arm is another common site for insulin injections, but it is not the fastest. The absorption rate from the upper arm is generally faster than the thigh but slower than the abdomen. This site can be convenient for injections, especially for those who find it difficult to reach other areas.
Choice C reason:
Injections in the buttocks have the slowest absorption rate among the common injection sites. The buttocks are less commonly used for insulin injections due to the slower absorption rate and the difficulty some individuals may have in administering injections in this area. The high fat content in the buttocks slows down the absorption of insulin.
Choice D reason:
Injections in the abdomen provide the fastest absorption rate for insulin. The abdomen is the preferred site for many people with diabetes because it has a large surface area and is easy to access. The insulin injected into the abdominal area is absorbed quickly into the bloodstream, making it the most effective site for rapid-acting insulin. This is particularly important for managing blood sugar levels around meal times.
Correct Answer is D
Explanation
Choice A reason:
Thickening of the walls of the ventricles is not typically associated with restrictive cardiomyopathy (RCM). This condition is more characteristic of hypertrophic cardiomyopathy (HCM), where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. In RCM, the walls of the ventricles are usually not thickened but become rigid due to fibrosis or infiltration, which restricts the heart’s ability to fill with blood during diastole.
Choice B reason:
Stretching of the ventricles is more commonly seen in dilated cardiomyopathy (DCM), not restrictive cardiomyopathy. In DCM, the heart’s ventricles become enlarged and weakened, which impairs the heart’s ability to pump blood efficiently. RCM, on the other hand, involves stiffening of the ventricular walls without significant dilation.
Choice C reason:
Thickening of the ventricular walls and septum is a hallmark of hypertrophic cardiomyopathy (HCM), not restrictive cardiomyopathy. In HCM, the thickened walls can obstruct blood flow and lead to various complications. RCM is characterized by the stiffening of the ventricular walls due to fibrosis or infiltration, which restricts diastolic filling.
Choice D reason:
When the ventricular tissue becomes fibrous and fatty is the correct description of restrictive cardiomyopathy (RCM). In RCM, the heart’s ventricles become stiff and less elastic due to fibrosis (scarring) or infiltration by abnormal substances, such as amyloid proteins. This rigidity impairs the heart’s ability to fill properly during diastole, leading to symptoms of heart failure
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