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 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.

A. Hyperpigmentation B. Weight loss C. Hypotension D. Diaphoresis

Correct Answer is A

Explanation

A. Hyperpigmentation: This can occur due to increased production of melanin-stimulating hormones in some cases of Cushing's syndrome.

B. Weight loss: Weight loss is not a common feature of Cushing's syndrome. Instead, it usually presents with weight gain, particularly in the trunk and face (leading to "moon face" and "buffalo hump").

C. Hypotension: Hypotension is more common in Addison's disease due to the lack of cortisol and aldosterone. Cushing's syndrome is associated with hypertension due to excess cortisol increasing blood pressure.

D. Diaphoresis: Excessive sweating is not a common symptom of Cushing's syndrome.

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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.)

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.)