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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Pain stimulation above the level of the spinal cord lesion can cause discomfort and an increase in sympathetic activity, but it is not the primary cause of an uncompensated cardiovascular response seen in autonomic dysreflexia. This condition typically results from stimuli below the level of the injury.

Choice B reason: Toxic accumulation of free radicals below the level of the injury can contribute to tissue damage and inflammation but is not the primary cause of the acute cardiovascular responses in autonomic dysreflexia. The condition is primarily triggered by noxious stimuli below the level of the injury.

Choice C reason: A distended bladder or rectum is a common cause of autonomic dysreflexia in patients with spinal cord injuries above the T6 level. This condition involves an exaggerated autonomic response to stimuli below the level of the injury, resulting in severe hypertension, bradycardia, and other cardiovascular symptoms. The distention of the bladder or rectum sends signals that the spinal cord cannot properly process, leading to an uncontrolled sympathetic response.

Choice D reason: An abnormal vagal response typically involves parasympathetic activity and can lead to symptoms such as bradycardia or fainting. However, it is not the primary cause of the sympathetic overactivity and hypertension seen in autonomic dysreflexia. The condition is driven by an imbalance in the autonomic nervous system due to spinal cord injury.

A. Prevent constipation B. Reduce flushing C. Minimize gingival hyperplasia D. Prevent reflex tachycardia

Correct Answer is D

Explanation

Choice A reason: Preventing constipation is not the primary reason for prescribing metoprolol alongside nifedipine. While managing side effects is important in patient care, metoprolol does not have a notable effect on gastrointestinal motility to address constipation.

Choice B reason: Reducing flushing is not the main purpose of metoprolol. Flushing can sometimes be a side effect of vasodilatory medications, but it is not the specific reason for adding a beta-blocker like metoprolol to a treatment regimen involving a calcium channel blocker like nifedipine.

Choice C reason: Minimizing gingival hyperplasia is not the intended effect of metoprolol. Gingival hyperplasia can be a side effect of certain medications, such as calcium channel blockers like nifedipine, but metoprolol does not specifically counteract this effect.

Choice D reason: Preventing reflex tachycardia is the primary reason for prescribing metoprolol alongside nifedipine. Nifedipine, a calcium channel blocker, can cause vasodilation, which may lead to a reflex increase in heart rate (tachycardia) as the body tries to maintain blood pressure. Metoprolol, a beta-blocker, helps prevent this reflex tachycardia by slowing the heart rate and reducing the workload on the heart, thus complementing the antihypertensive effect of nifedipine.

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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?

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Naxlex Comprehensive Predictor Exams

A patient diagnosed with a spinal cord injury experienced spinal shock lasting 15 days. The patient is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. What does the nurse suspect caused this condition?

Correct Answer is C

Explanation

A patient begins taking the calcium channel blocker, nifedipine [Procardia], along with metoprolol, to treat hypertension. The nurse understands that metoprolol is used to:

Correct Answer is D

Explanation

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