A client is prescribed Methylprednisolone 25mg IV every 6 hours.

The vial (after reconstitution) reads Methylprednisolone 80mg/mL. How many milliliters will be drawn up in the syringe? (Use a leading zero if it applies, Round to the nearest tenth, Do not use a trailing zero).

Choice A rationale

The epiphyseal plate, or growth plate, is a cartilaginous area responsible for longitudinal bone growth in children. A fracture in this region can disrupt the normal physiological process of endochondral ossification, potentially leading to premature fusion or damage to the growth cartilage, resulting in limb length discrepancies or angular deformities.

Choice B rationale

While significant trauma can cause localized damage, a fracture at the epiphyseal plate primarily impacts the cartilage growth process and is not typically associated with a systemic loss of bone marrow. Bone marrow is largely confined within the medullary cavity and trabecular spaces of the bone.

Choice C rationale

The healing process for fractures, including those at the epiphyseal plate, is generally faster in younger children due to their higher metabolic rate, increased cellular activity, and robust periosteal blood supply. Pediatric bones have excellent regenerative capacity compared to adult bones, leading to more rapid remodeling.

Choice D rationale

While severe fractures can compromise local blood supply, the epiphyseal plate itself receives its vascularization from specific metaphyseal and epiphyseal arteries. A fracture can disrupt this supply, but the primary concern with epiphyseal fractures is damage to the chondrocytes and the ongoing process of bone elongation.

Choice A rationale

Administering diuretics in SIADH can worsen hyponatremia by promoting water excretion with a concomitant loss of sodium, further diluting serum sodium concentration. The underlying issue in SIADH is excessive antidiuretic hormone leading to water retention, not primarily excess extracellular fluid that needs diuresis.

Choice B rationale

Increasing fluid intake is contraindicated in SIADH. The syndrome involves excessive reabsorption of water, leading to dilutional hyponatremia and fluid overload. Increasing fluid intake would exacerbate these issues, further lowering serum sodium levels and potentially leading to cerebral edema.

Choice C rationale

Restricting fluid intake is a cornerstone of SIADH management. By limiting water intake, the body's excessive water retention is mitigated, allowing serum sodium concentration to rise towards normal levels. This helps prevent further dilution of electrolytes and reduces the risk of fluid overload and cerebral edema.

Choice D rationale

Administering hypertonic 3% saline is an effective treatment for symptomatic severe hyponatremia in SIADH. This solution provides a concentrated source of sodium, helping to raise serum sodium levels by drawing water out of cells and into the extracellular space, thereby correcting the dilutional hyponatremia.