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When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says:

I should weigh myself daily and report any sudden weight loss or gain."

I need to limit my ﬂuid intake to no more than 1 quart of liquids a day,"

I will eat foods high in potassium because the diuretics cause potassium loss.”

I need to shop for foods that are low in sodium and avoid adding salt to foods.

Answer and Explanation

The Correct Answer is C

The correct answer is c. I will eat foods high in potassium because the diuretics cause potassium loss.

Rationale for Choice A:

Statement: "I should weigh myself daily and report any sudden weight loss or gain."
Rationale: This statement is correct. It's crucial for patients with SIADH to monitor their weight daily as even slight fluctuations can signal fluid imbalances. Sudden weight gain can indicate fluid retention, while sudden weight loss might suggest dehydration. Both scenarios warrant medical attention.

Rationale for Choice B:

Statement: "I need to limit my fluid intake to no more than 1 quart of liquids a day."
Rationale: This statement is also correct. Fluid restriction is a cornerstone of SIADH management. By limiting fluid intake, patients can help prevent the buildup of excess fluid in the body, which can lead to complications such as hyponatremia (low sodium levels in the blood) and edema.

Rationale for Choice C:

Statement: "I will eat foods high in potassium because the diuretics cause potassium loss."
Rationale: This statement is incorrect. While some diuretics used in the treatment of SIADH can indeed cause potassium loss, this is not a universal side effect. Furthermore, increasing potassium intake without medical supervision can be dangerous, potentially leading to hyperkalemia (high potassium levels in the blood). It's essential for patients to consult with their healthcare providers for individualized guidance on potassium intake.

Rationale for Choice D:

Statement: "I need to shop for foods that are low in sodium and avoid adding salt to foods."
Rationale: This statement is correct. A low-sodium diet is often recommended for patients with SIADH to help manage fluid balance and prevent hyponatremia. Restricting sodium intake can reduce fluid retention and help maintain appropriate sodium levels in the blood.

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Correct Answer is C

Explanation

The nurse should act on the order to insert a 16 French retention catheter first. The patient's markedly distended bladder and agitated and confused state suggest acute urinary retention, which can be relieved by inserting a catheter to drain the urine. This is a priority intervention as urinary retention can lead to serious complications such as bladder rupture, hydronephrosis, and renal failure. Once the catheter is inserted and the patient's bladder is drained, the healthcare provider can order further tests such as an IVP or blood tests to assess renal function. The order for lorazepam can be addressed after the catheter is inserted and the patient's urinary retention is addressed.

A. 09:00 AM and 11:00 AM B. 08:00 AM and 10:00 AM C. 07:00 AM and 09:00 AM D. 12:00 PM and 3:00 PM

Correct Answer is A

Explanation

The peak time of 70/30 NPH/regular insulin premix is usually 2 to 12 hours after injection, with an average peak time of 4 to 6 hours. This means that the highest risk of hypoglycemia is typically 4 to 6 hours after the injection, which would fall between 11:00 AM and 1:00 PM. However, it's important to note that hypoglycemic reactions can occur at any time, so the client should be monitored closely throughout the day for any signs or symptoms of low blood sugar.

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When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says:

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Correct Answer is A

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