A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

Decreasing serum sodium

Decreasing blood glucose

Decreasing serum potassium

Increasing urinary output

Answer and Explanation

The Correct Answer is D

One of the hallmarks of adrenal insufficiency is dehydration and decreased urinary output, which can lead to electrolyte imbalances such as hyperkalemia and hyponatremia. As treatment begins to take eﬀect, the patient's ﬂuid and electrolyte balance should improve, leading to an increase in urinary output. Acute adrenal insufficiency, also known as the Addisonian crisis, is a life-threatening condition caused by a sudden decrease in cortisol and aldosterone hormones. Treatment usually involves the administration of intravenous glucocorticoids and mineralocorticoids to replace the deficient hormones.
Decreasing serum sodium (a) and decreasing blood glucose (b) are not signs of improvement but rather indicative of continued adrenal insufficiency. Decreasing serum potassium (c) is also not a sign of improvement as it could indicate that the patient is developing hyperkalemia, which is a potential complication of adrenal crisis.

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Correct Answer is C

Explanation

The correct answer is c. I will eat foods high in potassium because the diuretics cause potassium loss.

Rationale for Choice A:

Statement:"I should weigh myself daily and report any sudden weight loss or gain."
Rationale:This statement is correct.It's crucial for patients with SIADH to monitor their weight daily as even slight fluctuations can signal fluid imbalances.Sudden weight gain can indicate fluid retention,while sudden weight loss might suggest dehydration.Both scenarios warrant medical attention.

Rationale for Choice B:

Statement:"I need to limit my fluid intake to no more than 1 quart of liquids a day."
Rationale:This statement is also correct.Fluid restriction is a cornerstone of SIADH management.By limiting fluid intake,patients can help prevent the buildup of excess fluid in the body,which can lead to complications such as hyponatremia (low sodium levels in the blood) and edema.

Rationale for Choice C:

Statement:"I will eat foods high in potassium because the diuretics cause potassium loss."
Rationale:This statement is incorrect.While some diuretics used in the treatment of SIADH can indeed cause potassium loss,this is not a universal side effect.Furthermore,increasing potassium intake without medical supervision can be dangerous,potentially leading to hyperkalemia (high potassium levels in the blood).It's essential for patients to consult with their healthcare providers for individualized guidance on potassium intake.

Rationale for Choice D:

Statement:"I need to shop for foods that are low in sodium and avoid adding salt to foods."
Rationale:This statement is correct.A low-sodium diet is often recommended for patients with SIADH to help manage fluid balance and prevent hyponatremia.Restricting sodium intake can reduce fluid retention and help maintain appropriate sodium levels in the blood.

A. Peppermint tea might be helpful in reducing your symptoms. B. You should avoid eating between meals to avoid acid secretion. C. You will need to keep the head of your bed elevated on blocks. D. Vigorous physical activities may increase the incidence of reﬂux.

Correct Answer is C

Explanation

When teaching a patient with newly diagnosed GERD, the nurse will include that they will need to keep the head of their bed elevated on blocks. This helps prevent stomach acid from ﬂowing back into the esophagus while sleeping.

Peppermint tea might not be helpful in reducing GERD symptoms as it can relax the lower esophageal sphincter and worsen reﬂux.

Eating between meals is not recommended as it can increase acid secretion. Vigorous physical activities may increase the incidence of reﬂux.

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A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

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Naxlex Comprehensive Predictor Exams

When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says:

Correct Answer is C

Explanation

Which information will the nurse include when teaching a patient with newly diagnosed GERD?

Correct Answer is C

Explanation

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