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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Placing the patient in a lateral recovery position is the best immediate action. This position helps facilitate drainage of secretions, especially after a laryngectomy, which can reduce the risk of aspiration and airway obstruction. The blood-tinged mucus may be due to recent surgery and should be monitored for changes.
B. The activation of the rapid-response team may be necessary if the patient’s condition worsens or becomes critical, but there is no indication of an acute life-threatening event based on the blood-tinged mucus alone.
C. Monitoring the oxygen saturation and respiratory rate is important, but it is a secondary concern compared to providing a position that promotes drainage and prevents aspiration.
D. Increasing humidification of the oxygen may help keep the airway moist, but the immediate priority should be ensuring proper positioning to allow secretion drainage and prevent aspiration.
Correct Answer is C
Explanation
A. Furosemide is a diuretic that is used to reduce fluid overload and manage conditions like heart failure or kidney disease. It is not indicated in anaphylaxis.
B. Methylprednisolone is a corticosteroid used for its anti-inflammatory properties and can be used in anaphylaxis to reduce inflammation and prevent delayed reactions. However, it is not the first-line treatment in acute anaphylactic shock.
C. Epinephrine is the first-line treatment for anaphylactic shock. It works by rapidly reversing the effects of anaphylaxis, such as bronchoconstriction, vasodilation, and edema, by stimulating alpha and beta receptors. Epinephrine should be administered as soon as anaphylaxis is suspected to stabilize the patient’s condition.
D. Dobutamine is a medication used to manage shock by increasing cardiac output, but it is not used in the management of anaphylactic shock. The priority is epinephrine to reverse the anaphylactic response.
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