A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia?
(Select All that Apply.)

Urine specific gravity of 1.010 (1.005 - 1.03)

Respiratory alkalosis

Diarrhea

Confusion

Diminished reflexes

Answer and Explanation

Correct Answer : D,E

A. Urine specific gravity of 1.010 (1.005 - 1.03): A urine specific gravity of 1.010 is within the normal range and does not indicate the concentrated urine typically seen in SIADH. Therefore, it is not associated with hyponatremia in SIADH.

B. Respiratory alkalosis: Respiratory alkalosis is related to an imbalance in carbon dioxide levels, not directly to sodium levels. It is not a manifestation of hyponatremia or SIADH.

C. Diarrhea: Diarrhea is not a direct manifestation of hyponatremia. While it can cause electrolyte imbalances, hyponatremia in SIADH is more related to water retention and dilution of sodium.

D. Confusion: Confusion is a common neurological symptom of hyponatremia due to the osmotic imbalance affecting brain cells. This is often seen in clients with SIADH as low sodium levels affect brain function.

E. Diminished reflexes: Diminished reflexes can occur in hyponatremia as it affects neuromuscular function, leading to decreased responsiveness of the nervous system. This can be observed in clients with SIADH.

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Correct Answer is D

Explanation

A. Bradycardia: Bradycardia, or a slow heart rate, is not typically associated with diabetes insipidus. Diabetes insipidus usually involves dehydration, which can lead to tachycardia (fast heart rate) as the body attempts to maintain adequate blood flow despite low fluid volume.

B. Polyphagia: Polyphagia, or excessive hunger, is typically a symptom of diabetes mellitus due to hyperglycemia. Diabetes insipidus is characterized by excessive urination and thirst, not increased hunger.

C. Hyperglycemia: Hyperglycemia is related to diabetes mellitus. Diabetes insipidus involves a problem with antidiuretic hormone (ADH) leading to excessive urine production and dehydration, not issues with blood sugar levels.

D. Dehydration: Dehydration is a primary concern in diabetes insipidus because of the excessive loss of water through urine. Patients are unable to concentrate their urine due to a deficiency in ADH or renal resistance to it, leading to significant fluid loss and dehydration.

A. Restrict fluid intake. B. Weigh the client daily. C. Provide a low-carbohydrate diet. D. Administer oral corticosteroids.

Correct Answer is D

Explanation

A. Restrict fluid intake: In Addison's disease, there is often a risk of dehydration due to insufficient aldosterone leading to fluid loss and electrolyte imbalance. Fluid restriction could exacerbate these problems and is contraindicated.

B. Weigh the client daily. Monitoring daily weight is crucial to detect rapid weight changes which can indicate fluid imbalance, a common issue in Addison's disease. It helps in early detection of complications like dehydration or fluid overload.

C. Provide a low-carbohydrate diet. A low-carbohydrate diet is not specifically recommended for Addison's disease. Clients with Addison’s might need an adequate intake of carbohydrates to prevent hypoglycemia, particularly during stress or illness.

D. Administer oral corticosteroids. Addison's disease is characterized by insufficient production of corticosteroids. Administering oral corticosteroids is essential to replace the missing hormones and prevent an Addisonian crisis, especially during stress or illness.

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A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia? (Select All that Apply.)

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A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia?
(Select All that Apply.)