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 B

Explanation

A. Hypoglycemia: Hypoglycemia is not directly related to low potassium levels. While electrolyte imbalances can impact overall metabolic processes, hypoglycemia is more commonly associated with insulin use or other medications, rather than hypokalemia.

B. Cardiac dysrhythmias: Hypokalemia (potassium level of 3.3 mEq/L) is associated with an increased risk of cardiac dysrhythmias because potassium is crucial for normal electrical activity in the heart. Low potassium can lead to abnormal heart rhythms, which can be dangerous and life-threatening.

C. Neurogenic shock: Neurogenic shock is typically related to a sudden loss of sympathetic nervous system signals, often from spinal cord injury, and is not directly associated with low potassium levels.

D. Seizures: Seizures are not a common complication of hypokalemia. They are more often related to severe electrolyte imbalances like low sodium, or neurological conditions, rather than low potassium.

A. Insert the IV catheter. B. Initiate oxygen therapy. C. Attach the leads for a 12-lead ECG. D. Obtain a blood sample.

Correct Answer is C

Explanation

A. Insert the IV catheter: Establishing IV access is necessary for medication administration, but it should follow the ECG to confirm the diagnosis and direct further treatment.

B. Initiate oxygen therapy: While oxygen can be important to increase myocardial oxygenation, it is typically administered after confirming the MI. Current guidelines recommend oxygen therapy primarily for patients with oxygen saturation below 90%.

C. Attach the leads for a 12-lead ECG: The 12-lead ECG is the most critical initial step as it is the definitive diagnostic tool for identifying and confirming a myocardial infarction (MI). It helps to determine the type and extent of the MI, which guides subsequent treatment decisions. Quick identification of an MI is crucial for timely intervention.

D. Obtain a blood sample: Blood tests, including cardiac enzyme measurements, are important but secondary to the ECG in the acute phase for diagnosing an MI.

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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.)