A nurse is preparing to administer medications to a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following medications should the nurse question?
Conivaptan hydrochloride 20 mg IV over 30 minutes STAT
Vasopressin 10 mcg PO daily
Sodium chloride tablets 1 g PO three times daily
Tolvaptan 30 mg PO twice daily
The Correct Answer is B
Choice A Reason:
Conivaptan hydrochloride is a vasopressin receptor antagonist used to treat hyponatremia associated with SIADH. It works by blocking the action of ADH, thereby promoting water excretion without losing sodium. This medication is appropriate for managing SIADH.
Choice B Reason:
Vasopressin, also known as antidiuretic hormone (ADH), is not appropriate for a patient with SIADH. SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Administering vasopressin would exacerbate the condition by increasing water retention and further lowering sodium levels.
Choice C Reason:
Sodium chloride tablets are used to manage hyponatremia by increasing sodium levels in the blood. This treatment is appropriate for patients with SIADH to help correct the sodium imbalance caused by excessive ADH.
Choice D Reason:
Tolvaptan is another vasopressin receptor antagonist that is used to treat hyponatremia associated with SIADH. It helps to increase serum sodium levels by promoting water excretion while retaining sodium. This medication is suitable for managing SIADH.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
Choice A Reason:
Acetaminophen is often used to manage pain and fever associated with pericarditis. It is a common analgesic and antipyretic that helps alleviate discomfort without causing significant gastrointestinal side effects. However, it does not have anti-inflammatory properties, so it is typically used in conjunction with other medications that address inflammation.
Choice B Reason:
Amiodarone is an antiarrhythmic medication used to treat and prevent various types of serious irregular heartbeats, such as ventricular tachycardia or ventricular fibrillation. It is not typically used for treating pericarditis, as it does not address the inflammation or pain associated with the condition.
Choice C Reason:
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is effective in reducing inflammation and pain associated with pericarditis. NSAIDs are commonly prescribed for pericarditis to help manage symptoms and reduce inflammation. Indomethacin, along with other NSAIDs like ibuprofen, is often part of the first-line treatment for this condition.
Correct Answer is C
Explanation
Choice A reason: Synchronized Electrical Cardioversion
Synchronized electrical cardioversion is a procedure that uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle to restore a normal heart rhythm. It is typically used to treat certain types of arrhythmias, such as atrial fibrillation, atrial flutter, and supraventricular tachycardia. However, it is not the primary treatment for heart failure with arrhythmias. This procedure is more suited for acute management of arrhythmias rather than long-term regulation of heart rhythm in heart failure patients.
Choice B reason: Heart Catheterization with Percutaneous Intervention
Heart catheterization with percutaneous intervention, also known as percutaneous coronary intervention (PCI), involves using a catheter to open up blocked coronary arteries. This procedure is primarily used to treat coronary artery disease and improve blood flow to the heart muscle. While it can alleviate symptoms of heart disease and prevent heart attacks, it does not directly address the issue of arrhythmias associated with heart failure. Therefore, it is not the most appropriate choice for regulating heart rhythm in this context.
Choice C reason: Cardiac Resynchronization Therapy (CRT)
Cardiac resynchronization therapy (CRT) is a specialized treatment for heart failure patients who have developed arrhythmias. CRT involves implanting a device called a biventricular pacemaker, which sends electrical signals to both the left and right ventricles to help them contract in a more synchronized manner. This improves the efficiency of the heart’s pumping action and can significantly alleviate symptoms of heart failure, such as shortness of breath and fatigue. CRT is particularly beneficial for patients with moderate to severe heart failure and those whose heart chambers do not beat in unison. This makes CRT the most appropriate choice for regulating heart rhythm in a patient with worsening heart failure and arrhythmias.
Choice D reason: Echocardiogram
An echocardiogram is a diagnostic test that uses ultrasound waves to create images of the heart. It provides detailed information about the heart’s structure and function, including the size and shape of the heart chambers, the movement of the heart walls, and the function of the heart valves. While an echocardiogram is essential for diagnosing and monitoring heart conditions, it is not a treatment procedure. It does not regulate heart rhythm but rather helps in assessing the severity of heart failure and guiding treatment decisions.
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