A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) may present with which of the following symptoms?

Hypotension

Dry mucous membranes

Increased thirst

Confusion or altered mental status

Answer and Explanation

The Correct Answer is D

A. Hypotension: Patients with SIADH typically have fluid retention, which can lead to hypertension, not hypotension.

B. Dry mucous membranes: In SIADH, fluid retention is common, so mucous membranes are usually moist, not dry.

C. Increased thirst: While thirst can occur in various conditions, it is not a primary symptom of SIADH.

D. Confusion or altered mental status: Confusion or altered mental status may occur in SIADH due to hyponatremia from excessive water retention.

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Correct Answer is A

Explanation

A. Hypovolemia leading to decreased renal perfusion. Hypovolemia from dehydration and low blood pressure reduces blood flow to the kidneys, resulting in pre-renal AKI, characterized by elevated BUN and creatinine.

B. Acute tubular necrosis. Acute tubular necrosis may cause AKI but is often due to prolonged hypoperfusion, nephrotoxic drugs, or ischemia, not the immediate presentation seen here.

C. Urinary tract obstruction. A urinary tract obstruction leads to post-renal AKI, often with symptoms like flank pain or difficulty urinating, not dehydration and low blood pressure.

D. Chronic kidney disease. Chronic kidney disease is a long-term condition and would not cause the acute symptoms or sudden onset of AKI as seen in this patient.

A. A clean catch urinalysis and urine culture B. Foley catheter placement C. Broad-spectrum antibiotic D. 0.9% sodium chloride infusion at 100 ml/hr E. WBC count F. Blood cultures × 2

Correct Answer is ["A","C","E"]

Explanation

A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.

B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.

C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.

D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.

E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.

F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.

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A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) may present with which of the following symptoms?

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Correct Answer is A

Explanation

A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?

Correct Answer is ["A","C","E"]

Explanation

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