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 A

Explanation

A. HbA1c = 5.6%. HbA1c measures the average blood glucose levels over the past 2-3 months. A level of 5.6% is within the normal range (below 5.7%), indicating good glycemic control. This suggests that the client’s diabetes is well managed, potentially indicating that the beta cells are functioning well and insulin sensitivity has improved.

B. Client reports smoking cessation: While smoking cessation is very beneficial for overall health and can improve diabetes management, it does not directly indicate beta cell function restoration. It is more related to reducing cardiovascular risks and improving long-term health outcomes.

C. Weight gain of 5 lb: Weight gain is not typically a sign of improving beta cell function. In fact, weight gain can sometimes indicate poor control of diabetes, as insulin resistance can worsen with increased weight. It is not a direct measure of beta cell activity.

D. Fasting blood glucose of 140 mg/dL: A fasting blood glucose of 140 mg/dL is above the normal range and suggests poor glycemic control, indicating that beta cells are not functioning adequately to maintain normal glucose levels. This value points to ongoing issues with insulin resistance or secretion.

A. Maintain oxygen saturations greater than or equal to 92%. B. Obtain an EKG. C. Administer enteric-coated acetaminophen. D. Administer ibuprofen.

Correct Answer is B

Explanation

A. Maintain oxygen saturations greater than or equal to 92%: Maintaining oxygen saturation is important but is not the immediate priority. The symptoms suggest a possible myocardial infarction (heart attack), and the primary focus should be on immediate diagnostic assessment and treatment.

B. Obtain an EKG: The symptoms described (pain in the jaw, back, and shoulder, along with shortness of breath and nausea) are classic signs of a myocardial infarction. An EKG is essential to quickly diagnose this potentially life-threatening condition and guide further treatment.

C. Administer enteric-coated acetaminophen: Acetaminophen is typically used for pain relief or fever reduction, not for the treatment of symptoms that may indicate a heart attack. It does not address the potential underlying cause, which is more serious.

D. Administer ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that may provide pain relief but is not appropriate for a suspected myocardial infarction. NSAIDs can also potentially increase the risk of cardiovascular events and would not be suitable in this context.

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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.)