A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone. Which of the following findings should the nurse expect?
Excessive urinary output
Elevated sodium level
Bounding peripheral pulses
Hyperactive deep tendon reflexes
The Correct Answer is C
A. Excessive urinary output: In syndrome of inappropriate antidiuretic hormone (SIADH), there is decreased urinary output, not excessive output. The body retains water due to increased antidiuretic hormone (ADH), leading to fluid retention.
B. Elevated sodium level: Due to excessive water retention and dilution of electrolytes, clients with SIADH typically experience hyponatremia (decreased sodium level), not an elevated sodium level. The retained water dilutes the body's sodium concentration.
C. Bounding peripheral pulses: Bounding peripheral pulses are expected in SIADH due to fluid overload, as the body retains excessive water. This leads to increased blood volume and can cause the peripheral pulses to feel strong or "bounding."
D. Hyperactive deep tendon reflexes: Hyperactive deep tendon reflexes are typically associated with conditions such as hypercalcemia or hyperthyroidism, not SIADH. SIADH is more likely to cause muscle weakness and fatigue due to hyponatremia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Excessive urinary output: In syndrome of inappropriate antidiuretic hormone (SIADH), there is decreased urinary output, not excessive output. The body retains water due to increased antidiuretic hormone (ADH), leading to fluid retention.
B. Elevated sodium level: Due to excessive water retention and dilution of electrolytes, clients with SIADH typically experience hyponatremia (decreased sodium level), not an elevated sodium level. The retained water dilutes the body's sodium concentration.
C. Bounding peripheral pulses: Bounding peripheral pulses are expected in SIADH due to fluid overload, as the body retains excessive water. This leads to increased blood volume and can cause the peripheral pulses to feel strong or "bounding."
D. Hyperactive deep tendon reflexes: Hyperactive deep tendon reflexes are typically associated with conditions such as hypercalcemia or hyperthyroidism, not SIADH. SIADH is more likely to cause muscle weakness and fatigue due to hyponatremia.
Correct Answer is C
Explanation
A. "Plan to void every 6 hours.": Voiding every 6 hours may not be appropriate for clients with stress incontinence. A more individualized schedule based on the client's needs and fluid intake is better. Holding urine for too long could worsen symptoms.
B. "Squeeze your legs together when you feel the urge to void.": This is not effective in managing stress incontinence. Instead, strategies like pelvic muscle exercises (Kegel exercises) can help strengthen the muscles that control urination.
C. "Perform Kegel exercises three times daily.": Kegel exercises help strengthen the pelvic floor muscles, which can reduce stress incontinence by improving bladder control. This is an effective and recommended strategy for managing the condition.
D. "Drink 1 liter of fluids a day.": Restricting fluids can concentrate urine, irritating the bladder and worsening incontinence. It’s generally better to maintain adequate hydration, typically around 2 liters of fluids daily, unless otherwise directed by the healthcare provider.
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