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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Cerebral edema is the most dangerous complication associated with the administration of hypotonic fluids in patients with diabetic ketoacidosis (DKA). This occurs because hypotonic fluids cause rapid shifts in fluid and electrolytes, which can lead to swelling of the brain, especially in children. The risk is heightened if fluids are replaced too quickly.
B. Polyuria is a common symptom of diabetic ketoacidosis due to high blood glucose levels and osmotic diuresis, but it is not caused by hypotonic fluid administration.
C. Hypokalemia is a potential risk in DKA but typically arises from the shift of potassium from the extracellular to intracellular space during treatment, especially with insulin administration, not from the use of hypotonic fluids.
D. Metabolic acidosis is a hallmark of diabetic ketoacidosis itself and is caused by the accumulation of ketones. It is not caused by hypotonic fluid replacement.
Correct Answer is D
Explanation
A. A BMI of 28 kg/m² is considered overweight, but it does not meet the threshold for bariatric surgery, which typically requires a BMI of 40 or more.
B. While a BMI of 32 kg/m² may be relevant when combined with significant co-morbidities (like type 2 diabetes or hypertension), the standard guideline for bariatric surgery generally requires a BMI of 40 or higher, or 35 with comorbid conditions.
C. A BMI of 30 kg/m² is classified as obese, but bariatric surgery is generally considered for those with a BMI of 40 or higher, or 35 with severe comorbidities.
D. A BMI of 40 kg/m² or more is the standard criteria for bariatric surgery, particularly when other treatments (such as diet, exercise, and medication) have failed, or when obesity-related health issues are present.
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