A client who has small cell carcinoma of the lung is admitted with symptoms of syndrome of inappropriate antidiuretic hormone (SIADH). As the client responds to treatment, the client's serum sodium level increases from 120 mEq/L (120 mmol/L) to 125 mEq/L (125 mmol/L). Based on this finding, which intervention should the nurse implement?Reference Range:
Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]
Assess for increasing fluid volume overload.
Withhold next scheduled dose of treatment.
Increase neurologic checks to every 2 hours.
Maintain the prescribed fluid restriction.
The Correct Answer is D
A. Assessing for increasing fluid volume overload is not indicated with a rising serum sodium level; instead, it suggests correction of hyponatremia, a common complication of SIADH.
B. Withholding the next scheduled dose of treatment is not appropriate based solely on a rise in serum sodium level within the normal range.
C. Increasing neurologic checks may be necessary in severe cases of hyponatremia but is not directly indicated by a rise in serum sodium within the normal range.
D. Maintaining the prescribed fluid restriction is essential to prevent further dilutional hyponatremia and to help normalize the serum sodium level gradually.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E","F"]
Explanation
A. Obesity is a significant risk factor for gout as it can increase uric acid production and decrease its excretion.
B. Hypertension is commonly associated with gout, potentially due to shared risk factors including kidney health and certain medications that can raise uric acid levels.
C. Alcohol, especially beer, is a well-known trigger for gout attacks because it increases uric acid production and reduces its excretion.
D. Low doses of aspirin can increase uric acid levels by reducing its excretion through the kidneys.
E. While not a direct risk factor, type 2 diabetes is often associated with metabolic syndrome, which includes several risk factors for gout.
F. Research suggests a link between sleep apnea and increased risk of gout, possibly through the effects of intermittent hypoxia on uric acid levels.
G. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are typically used to treat gout attacks and do not generally increase the risk of developing gout. They can, however, affect kidney function with prolonged use.
H. Smoking is not directly linked to gout risk; smoking cessation is generally beneficial for overall health but does not increase gout risk.
I. Osteoarthritis is a different type of joint disease and does not increase the risk of developing gout.
Correct Answer is ["A","B"]
Explanation
In the provided scenario, the two key pieces of subjective data indicating the need for health interventions are the client's report of using a rescue inhaler multiple times without relief and the exacerbation of symptoms when outdoors and during exercise. These details suggest that the client's asthma is not well-controlled, and the ineffectiveness of the rescue medication, especially with an expired inhaler, warrants immediate medical attention.
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