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 B
Explanation
A. While avoiding infection is important for individuals with Addison's disease due to their weakened immune system, the priority is ensuring proper medication management.
B. Managing lifelong corticosteroid replacement is the most crucial instruction because individuals with Addison's disease have insufficient production of adrenal hormones, particularly cortisol. Without appropriate corticosteroid therapy, they can experience life-threatening adrenal crises.
C. Wearing a Medic-Alert bracelet is a helpful precaution, but it is not as immediately critical as ensuring proper medication management.
D. Practicing stress-management techniques is beneficial, as stress can exacerbate symptoms of Addison's disease, but corticosteroid replacement remains the highest priority.
Correct Answer is B
Explanation
A. Formoterol is a long-acting beta agonist (LABA) used for maintenance therapy, not for aborting acute asthma attacks. LABAs help prevent asthma symptoms but are not effective for immediate relief during an acute attack.
B. Albuterol is a short-acting beta agonist (SABA), which is the medication of choice for relieving acute asthma symptoms. It acts quickly to relax the muscles of the airways and relieve bronchospasm.
C. Beclomethasone is an inhaled corticosteroid used for long-term asthma control, reducing inflammation, but it is not used to treat acute attacks.
D. Salmeterol is another LABA, similar to formoterol, and is not used for aborting acute asthma attacks but rather for long-term control.
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