A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?
Hyperkalemia
Hypokalemia
Hyponatremia
Hypercalcemia
The Correct Answer is C
Choice A reason: Hyperkalemia, or elevated potassium levels in the blood, is not typically seen in patients with SIADH. SIADH is primarily characterized by water retention and the resultant dilution of electrolytes, most notably sodium. Potassium levels are not directly affected by the antidiuretic hormone (ADH) abnormalities present in SIADH, and thus hyperkalemia is not an expected finding.
Choice B reason: Hypokalemia, which refers to low potassium levels in the blood, is also not a characteristic feature of SIADH. While potassium imbalances can occur due to a variety of conditions and medications, they are not the hallmark of SIADH. The syndrome's primary effect on electrolyte balance involves sodium, not potassium.
Choice C reason: Hyponatremia, or low sodium levels in the blood, is the defining feature of SIADH. In this condition, excessive secretion of antidiuretic hormone (ADH) leads to increased water reabsorption in the kidneys. This excess water dilutes the sodium in the bloodstream, leading to hyponatremia. The resulting imbalance can cause symptoms ranging from mild (such as headache and nausea) to severe (such as seizures and altered mental status), depending on the degree of sodium depletion.
Choice D reason: Hypercalcemia, or high calcium levels in the blood, is not associated with SIADH. The condition of SIADH affects water and sodium balance due to inappropriate ADH secretion but does not typically influence calcium levels. Hypercalcemia can be seen in other conditions, such as hyperparathyroidism or malignancies, but it is not related to the pathophysiology of SIADH.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Compensated metabolic acidosis is characterized by a low pH (acidemia) with a compensatory decrease in PaCO2 due to hyperventilation, and typically a low HCO3 as well. In this scenario, the pH is elevated (alkalemia), which rules out metabolic acidosis.
Choice B reason: Compensated metabolic alkalosis is characterized by a high pH (alkalemia) with a compensatory increase in PaCO2 due to hypoventilation, and a high HCO3. In this case, the PaCO2 is low rather than high, and the HCO3 is within the normal range, which rules out metabolic alkalosis.
Choice C reason: Respiratory alkalosis is characterized by a high pH (alkalemia) and a low PaCO2, indicating that the alkalosis is due to excessive loss of CO2 through hyperventilation. The HCO3 is usually normal or slightly decreased as a compensatory mechanism. The provided ABG values (pH = 7.53, PaCO2 = 23, HCO3 = 22) are consistent with respiratory alkalosis, where the elevated pH and low PaCO2 point towards hyperventilation as the cause of the alkalemia.
Choice D reason: Uncompensated respiratory alkalosis would present with a high pH and low PaCO2, without significant compensation by the kidneys (i.e., HCO3 would still be normal). In this scenario, the ABG values fit the description of respiratory alkalosis, but it is considered compensated since the HCO3 is within the normal range, indicating some level of renal compensation.
Correct Answer is ["A"]
Explanation
Choice A reason: Nucleoside reverse transcriptase inhibitors (NRTIs) are one of the main classes of antiretroviral drugs used in the treatment of HIV. They work by inhibiting the reverse transcriptase enzyme, which is crucial for the replication of the virus. By blocking this enzyme, NRTIs help prevent the virus from multiplying and reduce the viral load in the body.
Choice B reason: RNA transfer inhibitors are not a recognized class of drugs used in the management of HIV. The main classes of antiretroviral drugs include NRTIs, non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors, fusion inhibitors, integrase inhibitors, and entry inhibitors, but RNA transfer inhibitors are not among them.
Choice C reason: Fusion inhibitors are a class of antiretroviral drugs that prevent HIV from entering the host cells. They work by blocking the fusion process between the viral envelope and the host cell membrane, thereby preventing the virus from injecting its genetic material into the host cell. Fusion inhibitors are used as part of combination therapy to manage HIV infection.
Choice D reason: Protease inhibitors are another essential class of antiretroviral drugs used to treat HIV. They work by inhibiting the protease enzyme, which is necessary for the virus to produce mature viral particles. By blocking this enzyme, protease inhibitors prevent the production of functional viral particles, thus reducing the viral load in the body.
Choice E reason: DNA polymerase inhibitors are not used in the management of HIV. They are typically used to treat other viral infections, such as herpesviruses. The management of HIV primarily involves drugs that target the enzymes specific to HIV replication, such as reverse transcriptase, protease, and integrase
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