The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?

Serum potassium 5.0 mEq/L

Serum calcium 8.0 mg/dL

Serum sodium 125 mEq/L

Blood urea nitrogen (BUN) 24 mg/dL

Answer and Explanation

The Correct Answer is C

Choice A reason:

A serum potassium level of 5.0 mEq/L is within the normal range (3.5-5.0 mEq/L). While it is on the higher end of normal, it does not require immediate intervention in the context of SIADH. Potassium levels are crucial for cardiac and muscle function, but this value does not indicate a critical imbalance.

Choice B reason:

A serum calcium level of 8.0 mg/dL is slightly below the normal range (8.5-10.2 mg/dL). Mild hypocalcemia can occur in various conditions, but it is not typically associated with SIADH and does not require immediate intervention unless symptomatic or significantly lower.

Choice C reason:

A serum sodium level of 125 mEq/L indicates hyponatremia, which is a hallmark of SIADH. Hyponatremia can lead to severe neurological symptoms, including seizures, confusion, and coma, especially if it develops rapidly. Immediate intervention is required to correct the sodium imbalance and prevent serious complications.

Choice D reason:

A blood urea nitrogen (BUN) level of 24 mg/dL is within the upper normal range (7-20 mg/dL). While slightly elevated, it is not critically high and does not require immediate intervention in the context of SIADH. BUN levels can be influenced by various factors, including hydration status and renal function.

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Correct Answer is B

Explanation

Choice A Reason:

Conivaptan hydrochloride is a vasopressin receptor antagonist used to treat hyponatremia associated with SIADH. It works by blocking the action of ADH, thereby promoting water excretion without losing sodium. This medication is appropriate for managing SIADH.

Choice B Reason:

Vasopressin, also known as antidiuretic hormone (ADH), is not appropriate for a patient with SIADH. SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Administering vasopressin would exacerbate the condition by increasing water retention and further lowering sodium levels.

Choice C Reason:

Sodium chloride tablets are used to manage hyponatremia by increasing sodium levels in the blood. This treatment is appropriate for patients with SIADH to help correct the sodium imbalance caused by excessive ADH.

Choice D Reason:

Tolvaptan is another vasopressin receptor antagonist that is used to treat hyponatremia associated with SIADH. It helps to increase serum sodium levels by promoting water excretion while retaining sodium. This medication is suitable for managing SIADH.

A. Urine specific gravity of 1.010 (1.005-1.03) B. Respiratory alkalosis C. Diarrhea D. Diminished reflexes

Correct Answer is ["D"]

Explanation

Choice A Reason:

A urine specific gravity of 1.010 falls within the normal range of 1.005 to 1.0301. This value does not indicate hyponatremia. In SIADH, urine is often more concentrated due to the retention of water, leading to higher specific gravity values.

Choice B Reason:

Respiratory alkalosis is not a typical manifestation of hyponatremia. It is usually associated with conditions that cause hyperventilation, such as anxiety or high altitude. SIADH typically does not cause respiratory alkalosis.

Choice C Reason:

Diarrhea is not a direct manifestation of hyponatremia. While diarrhea can lead to electrolyte imbalances, including hyponatremia, it is not a symptom caused by SIADH5. SIADH leads to water retention and dilutional hyponatremia, not diarrhea.

Choice D Reason:

Diminished reflexes are a manifestation of hyponatremia. Low sodium levels affect neuromuscular function, leading to symptoms such as muscle weakness, cramps, and diminished reflexes7. This is a direct result of the electrolyte imbalance caused by SIADH.

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The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer medications to a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following medications should the nurse question?

Correct Answer is B

Explanation

A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia? (Select All that Apply)

Correct Answer is ["D"]

Explanation

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