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 B

Explanation

A. Cheyne-Stokes breathing is characterized by periods of deep breathing followed by apnea and is often associated with conditions like heart failure or brain injury, not diabetic ketoacidosis (DKA).
B. Acetone odor to breath is a hallmark sign of diabetic ketoacidosis. The body breaks down fats for energy, producing ketones, which are released in the breath, giving it a fruity or acetone-like odor.
C. A blood glucose level below 40 mg/dL would indicate hypoglycemia, not DKA. In DKA, blood glucose levels are typically elevated (above 250 mg/dL).
D. Malignant hypertension refers to extremely high blood pressure with organ damage, and is not directly related to diabetic ketoacidosis.

A. Maintain an IV of 0.45% sodium chloride. B. Restrict fluid intake to 1,000 mL per day. C. Provide a diet containing 2 g of sodium per day. D. Administer desmopressin acetate 0.2 mg orally.

Correct Answer is B

Explanation

A. Maintaining an IV of 0.45% sodium chloride would not be appropriate for SIADH because it is a hypotonic solution, and it could exacerbate the already low sodium levels in the patient, potentially worsening hyponatremia.
B. Fluid restriction is the primary treatment for SIADH as it helps reduce water retention, which is causing the dilution of sodium in the blood. Restricting fluid intake to 1,000 mL per day helps manage hyponatremia in these patients.
C. A diet containing 2 g of sodium per day is not typically indicated in SIADH. Restricting fluid is the main focus, and increasing sodium intake can often be counterproductive in SIADH, as the sodium imbalance is primarily due to excessive water retention.
D. Desmopressin acetate is typically used in diabetes insipidus, not SIADH. Desmopressin acts as an antidiuretic hormone (ADH) agonist, which would worsen the water retention in SIADH, not improve it.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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