In reviewing admission orders for a patient admitted with SIADH, the nurse should question which order?

IV 3% NS at 10 mL/hr

Seizure precautions

Fluid restriction of 1000 mL/day

Sodium-restricted diet

Answer and Explanation

The Correct Answer is A

A. In SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion), the body retains excessive water, leading to dilutional hyponatremia (low sodium levels). Administering hypertonic saline (3% NS) can exacerbate the condition by rapidly increasing sodium levels, which may cause demyelination of neurons (a condition called osmotic demyelination syndrome). Hypertonic saline is typically only used in severe hyponatremia with neurologic symptoms and should be carefully monitored.
B. Seizure precautions are appropriate in SIADH due to the risk of seizures from severe hyponatremia, which can lead to cerebral edema and neurological compromise.
C. Fluid restriction of 1000 mL/day is appropriate in SIADH to manage the dilutional hyponatremia by preventing further fluid retention.
D. A sodium-restricted diet is also recommended in SIADH to avoid further dilution of sodium levels and prevent worsening of hyponatremia.

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Correct Answer is D

Explanation

A. Insulin detemir is a long-acting basal insulin used for maintenance therapy, not for the rapid reduction of blood glucose levels in acute conditions like diabetic ketoacidosis (DKA).
B. NPH insulin is an intermediate-acting insulin used for long-term blood glucose control, but it is not appropriate for immediate treatment of DKA.
C. Insulin glargine is also a long-acting insulin that works over a prolonged period, making it unsuitable for emergency situations like DKA.
D. Regular insulin is the preferred choice for treating diabetic ketoacidosis. It is a short-acting insulin that can rapidly reduce blood glucose levels and is used intravenously for immediate intervention in DKA.

A. Take the medication with meals. B. Rinse the mouth after administration. C. Check the pulse after medication administration. D. Limit caffeine intake.

Correct Answer is B

Explanation

A. Taking inhaled beclomethasone with meals is not necessary, as this medication works locally in the lungs and does not require food to be absorbed or tolerated.
B. Rinsing the mouth after using inhaled corticosteroids like beclomethasone is important to prevent the development of oral thrush (a fungal infection) and reduce the risk of other side effects, such as hoarseness.
C. Checking the pulse after medication administration is not required for beclomethasone. While some medications affect heart rate, inhaled corticosteroids like beclomethasone are not typically associated with this effect.
D. Limiting caffeine intake is not necessary when using beclomethasone. Caffeine is a stimulant that may interact with some medications, but it does not typically interfere with corticosteroids used in asthma treatment.

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In reviewing admission orders for a patient admitted with SIADH, the nurse should question which order?

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Correct Answer is D

Explanation

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?

Correct Answer is B

Explanation

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