Edema is a hallmark sign of SIADH caused by fluid shifts into the extracellular space.
Clinical manifestations include concentrated urine output and overhydration.
A patient is recovering from a lung resection because of malignant bronchogenic small cell carcinoma.
His serum sodium is 120 mEq/L and SIADH is suspected.
Which statement is accurate regarding SIADH?
Management includes rapid restoration of serum sodium levels to normal.
SIADH occurs when excessive ADH is released by the anterior pituitary.
SIADH is characterized by diluted urine output and dehydration.
Serum sodium levels typically rise in cases of SIADH.
The Correct Answer is B
Choice A rationale
Rapid restoration of serum sodium levels can lead to central pontine myelinolysis, a severe neurological condition. Thus, management should be gradual.
Choice B rationale
SIADH occurs due to excessive release of antidiuretic hormone (ADH) from the posterior pituitary gland, not the anterior, leading to water retention and hyponatremia.
Choice C rationale
SIADH is characterized by concentrated urine due to water retention and overhydration, not diluted urine output and dehydration.
Choice D rationale
Serum sodium levels typically decrease in SIADH due to water retention and dilutional hyponatremia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale: Contact precautions are not necessary in this situation as the client is presenting symptoms of a possible infection related to chemotherapy-induced immunosuppression, not a contagious disease.
Choice B rationale: Placing the client in a private room is crucial to protect her from potential infections, given her compromised immune system due to chemotherapy.
Choice C rationale: Encouraging the client to increase fluid intake can help manage fever and muscle aches and keep her hydrated, which is important when dealing with symptoms of infection and fatigue.
Choice D rationale: Wearing a mask when caring for the client is necessary to protect both the client and the healthcare provider from potential infections, considering the client’s immunocompromised state.
Choice E rationale: Preparing to administer an antibiotic should be based on the healthcare provider's orders and further diagnostic results. While it might be necessary, it is not an immediate nursing action without provider confirmation.
Correct Answer is A
Explanation
Choice A rationale
Restricting foods containing potassium helps prevent hyperkalemia, a common metabolic imbalance in tumor lysis syndrome (TLS) due to the rapid release of intracellular potassium from lysed tumor cells.
Choice B rationale
Giving sodium polystyrene sulfonate is used to treat hyperkalemia, not hypokalemia. It works by binding potassium in the gut and helping excrete it from the body, but it is not a preventive measure for metabolic imbalances in TLS.
Choice C rationale
Keeping urine pH below 7.0 is not recommended for TLS. Alkalinizing the urine to a pH above 7.0 helps prevent uric acid crystallization and renal damage, which is crucial in managing TLS.
Choice D rationale
Restricting all oral fluids is not advisable for TLS. Adequate hydration is essential to support kidney function and enhance the excretion of electrolytes and uric acid, which helps prevent and manage TLS.
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