A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following actions should the nurse take?
Restrict oral fluids to 800 to 1,000 mL/day.
Maintain an IV of 0.45% sodium chloride.
Ensure the client receives a 2 g/day sodium diet.
Administer desmopressin acetate 0.2 mg orally.
The Correct Answer is A
a. Restrict oral fluids to 800 to 1,000 mL/day: Hyponatremia is a characteristic finding in SIADH, and fluid restriction is a key intervention to correct the imbalance.
b. Maintain an IV of 0.45% sodium chloride: Infusing hypertonic (3%) saline may be indicated in severe cases of hyponatremia, but the initial step is fluid restriction.
c. Ensure the client receives a 2 g/day sodium diet: Dietary sodium restriction is not the primary intervention for SIADH. Fluid restriction is more critical.
d. Administer desmopressin acetate 0.2 mg orally: Desmopressin acetate is an antidiuretic
hormone and would exacerbate the retention of water, further decreasing sodium levels. It is not the appropriate intervention for this client.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
a. Weight gain: Hyperthyroidism is more commonly associated with weight loss due to increased metabolism.
b. Constipation: Hyperthyroidism is more likely to cause diarrhea or increased bowel movements.
c. Frequent mood changes: Hyperthyroidism can lead to mood swings, irritability, and anxiety.
d. Sensitivity to cold: Sensitivity to cold is more commonly associated with hypothyroidism, not hyperthyroidism.
Correct Answer is A
Explanation
a. Potassium level of 3.0 mEq/L: Hypokalemia is a potential adverse effect of digoxin, and a
potassium level of 3.0 mEq/L is below the normal range. Low potassium levels can increase the risk of digoxin toxicity.
b. Heart rate of 66/min: A heart rate of 66/min is within the normal range. Digoxin is used to
treat conditions like atrial fibrillation, and the heart rate should be within an appropriate range for the client's condition.
c. BP of 132/82 mm Hg: Blood pressure within the normal range does not require immediate reporting in the context of digoxin administration.
d. Digoxin level of 1.2 ng/ml: The digoxin level of 1.2 ng/ml is within the therapeutic range, and it does not require immediate reporting.
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