A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia?
(Select All that Apply.)

Urine specific gravity of 1.010 (1.005 - 1.03)

Respiratory alkalosis

Diarrhea

Confusion

Diminished reflexes

Answer and Explanation

Correct Answer : D,E

A. Urine specific gravity of 1.010 (1.005 - 1.03): A urine specific gravity of 1.010 is within the normal range and does not indicate the concentrated urine typically seen in SIADH. Therefore, it is not associated with hyponatremia in SIADH.

B. Respiratory alkalosis: Respiratory alkalosis is related to an imbalance in carbon dioxide levels, not directly to sodium levels. It is not a manifestation of hyponatremia or SIADH.

C. Diarrhea: Diarrhea is not a direct manifestation of hyponatremia. While it can cause electrolyte imbalances, hyponatremia in SIADH is more related to water retention and dilution of sodium.

D. Confusion: Confusion is a common neurological symptom of hyponatremia due to the osmotic imbalance affecting brain cells. This is often seen in clients with SIADH as low sodium levels affect brain function.

E. Diminished reflexes: Diminished reflexes can occur in hyponatremia as it affects neuromuscular function, leading to decreased responsiveness of the nervous system. This can be observed in clients with SIADH.

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Correct Answer is A

Explanation

A. "Have an eye examination once per year." Annual eye examinations are essential for detecting diabetic retinopathy early. Early detection and treatment can help prevent vision loss. This is a key recommendation for managing diabetes-related eye complications.

B. "Examine your feet carefully every day." While daily foot examinations are important for preventing diabetic foot ulcers and other complications, they do not directly address the prevention of retinopathy and nephropathy, which are more related to blood glucose control and vascular health.

C. "Wear compression stockings daily." Compression stockings are used to manage conditions like chronic venous insufficiency and to prevent deep vein thrombosis, but they are not related to the prevention of diabetic retinopathy or nephropathy.

D. "Maintain stable blood glucose levels." Keeping blood glucose levels stable is crucial for preventing both retinopathy and nephropathy. Chronic hyperglycemia is a major risk factor for these complications, and good glycemic control reduces the risk of developing or worsening these conditions. This is also crucial but does not specifically target the complications as precisely as regular eye exams do.

A. Insert the IV catheter. B. Initiate oxygen therapy. C. Attach the leads for a 12-lead ECG. D. Obtain a blood sample.

Correct Answer is C

Explanation

A. Insert the IV catheter: Establishing IV access is necessary for medication administration, but it should follow the ECG to confirm the diagnosis and direct further treatment.

B. Initiate oxygen therapy: While oxygen can be important to increase myocardial oxygenation, it is typically administered after confirming the MI. Current guidelines recommend oxygen therapy primarily for patients with oxygen saturation below 90%.

C. Attach the leads for a 12-lead ECG: The 12-lead ECG is the most critical initial step as it is the definitive diagnostic tool for identifying and confirming a myocardial infarction (MI). It helps to determine the type and extent of the MI, which guides subsequent treatment decisions. Quick identification of an MI is crucial for timely intervention.

D. Obtain a blood sample: Blood tests, including cardiac enzyme measurements, are important but secondary to the ECG in the acute phase for diagnosing an MI.

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A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia? (Select All that Apply.)

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A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia?
(Select All that Apply.)