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 C

Explanation

A. Visual deterioration is not typically associated with nasal drainage following a hypophysectomy unless the optic nerves or structures are affected during surgery.
B. Diabetes is not related to the glucose content in the nasal drainage; it's unrelated to this situation.
C. The presence of glucose in the drainage indicates a possible cerebrospinal fluid (CSF) leak, as CSF contains glucose. A CSF leak increases the risk of meningitis due to the direct connection to the central nervous system.
D. Hypoglycemia is not associated with the glucose content of drainage fluid. This is more relevant to blood glucose levels.

A. Clubbing of the fingernails B. Tracheal deviation C. Contraction of the diaphragm D. Auscultation of rhonchi throughout the lungs

Correct Answer is B

Explanation

A. Clubbing of the fingernails is typically a sign of chronic hypoxia and is seen in conditions like cystic fibrosis, COPD, and other respiratory or cardiovascular diseases. It is a long-term issue and does not indicate an immediate emergency.
B. Tracheal deviation is a medical emergency and typically indicates tension pneumothorax, where air accumulates in the pleural space, shifting the trachea away from the affected side. This can compress the heart and lungs, leading to respiratory and circulatory collapse, requiring immediate action.
C. Contraction of the diaphragm may refer to normal breathing mechanics and does not indicate an immediate emergency unless it is associated with respiratory distress or failure.
D. Rhonchi are abnormal lung sounds often associated with mucus in the airways and can be heard in conditions like bronchitis or COPD. Although they may require attention, they do not represent an immediate emergency compared to tracheal deviation.

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

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Naxlex Comprehensive Predictor Exams

A patient's status post hypophysectomy had drainage on the mustache dressing. Which complication is this patient at risk for if the glucose level of the drainage is 50 mg/dL?

Correct Answer is C

Explanation

Which of the following assessment findings indicates an emergency and the need for immediate action on the part of the nurse?

Correct Answer is B

Explanation

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