A nurse is providing care for a client who has the syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings is consistent with a diagnosis of SIADH?
Increased serum sodium
Decreased serum osmolality
Decreased urinary sodium
Decreased urine osmolality
The Correct Answer is B
Choice A reason: Increased Serum Sodium
Increased serum sodium, or hypernatremia, is not consistent with SIADH. SIADH typically results in hyponatremia, which is a low level of sodium in the blood due to excessive water retention. The excess antidiuretic hormone (ADH) causes the kidneys to retain water, diluting the sodium in the bloodstream. Therefore, increased serum sodium is not a characteristic finding in SIADH.
Choice B reason: Decreased Serum Osmolality
Decreased serum osmolality is a hallmark of SIADH3. Serum osmolality measures the concentration of solutes in the blood. In SIADH, the excessive release of ADH leads to water retention, diluting the blood and lowering serum osmolality. This is a key diagnostic feature of SIADH and helps differentiate it from other conditions.
Choice C reason: Decreased Urinary Sodium
Decreased urinary sodium is not typically seen in SIADH. In fact, patients with SIADH usually have increased urinary sodium levels. This is because the kidneys excrete more sodium in an attempt to balance the excess water retained due to high ADH levels. Therefore, decreased urinary sodium is not consistent with SIADH.
Choice D reason: Decreased Urine Osmolality
Decreased urine osmolality is also not consistent with SIADH. In SIADH, urine osmolality is typically increased because the kidneys concentrate the urine due to the action of ADH. The high levels of ADH cause the kidneys to reabsorb water, resulting in more concentrated urine. Thus, decreased urine osmolality is not a characteristic finding in SIADH.
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Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Exercise
Exercise is a crucial component in the management of peripheral venous disease (PVD). Regular physical activity helps improve blood circulation and reduces symptoms such as pain and swelling. Walking, in particular, is highly recommended as it promotes venous return and enhances overall cardiovascular health. Exercise also helps in weight management, which can alleviate the pressure on the veins and improve symptoms of PVD.
Choice B reason: Elevation of Legs
Elevating the legs is a simple yet effective way to reduce swelling and improve blood flow in patients with PVD1. By raising the legs above the level of the heart, gravity helps to reduce the pooling of blood in the lower extremities, thereby decreasing edema and discomfort. This practice is especially beneficial when done regularly, such as during rest periods or while sleeping.
Choice C reason: Intermittent Pneumatic Compression Pumps
Intermittent pneumatic compression (IPC) pumps are devices used to enhance blood flow in the legs. These devices consist of inflatable sleeves that wrap around the legs and periodically inflate and deflate, mimicking the natural muscle contractions that help push blood back toward the heart. IPC pumps are particularly useful for patients who are immobile or have difficulty engaging in physical activity, as they help prevent blood clots and reduce swelling.
Choice D reason: Ankle-Brachial Index Test
The ankle-brachial index (ABI) test is a diagnostic tool used to assess the severity of peripheral artery disease (PAD), not peripheral venous disease. The test compares the blood pressure in the ankle with the blood pressure in the arm to determine the presence of arterial blockages. While the ABI test is important for diagnosing PAD, it is not a treatment or management strategy for PVD. Therefore, it is not included in the plan of care for PVD.
Choice E reason: Layered Wraps
Layered wraps, also known as compression bandages, are used to manage symptoms of PVD by providing consistent pressure to the legs. These wraps help reduce swelling, improve venous return, and prevent the formation of ulcers. Compression therapy is a cornerstone in the management of chronic venous insufficiency and related conditions, making layered wraps an essential part of the care plan for patients with PVD.
Correct Answer is A
Explanation
Choice A Reason:
Swollen and enlarged veins, also known as varicose veins, are a common manifestation of peripheral venous disease (PVD). This condition occurs when the valves in the veins become weak or damaged, leading to blood pooling and increased pressure within the veins. This results in the veins becoming enlarged, twisted, and visible under the skin1. Varicose veins can cause discomfort, pain, and a heavy feeling in the legs. They are often exacerbated by prolonged standing or sitting and can be a cosmetic concern as well.
Choice B Reason:
Loss of pigmentation over the shin area is not typically associated with peripheral venous disease. This symptom is more commonly seen in conditions such as chronic venous insufficiency (CVI), where prolonged venous hypertension leads to skin changes, including hyperpigmentation and lipodermatosclerosis. However, it is not a primary manifestation of PVD itself.
Choice C Reason:
A shiny appearance to the lower extremities is more commonly associated with peripheral arterial disease (PAD) rather than peripheral venous disease. In PAD, reduced blood flow to the extremities can cause the skin to become thin, shiny, and hairless. This is due to the lack of oxygen and nutrients reaching the skin and underlying tissues. In contrast, PVD primarily affects the veins and does not typically cause these skin changes.
Choice D Reason:
Diminished hair growth on the lower extremities is another symptom more commonly associated with peripheral arterial disease (PAD). In PAD, the reduced blood flow to the extremities can lead to hair loss, as the hair follicles do not receive adequate oxygen and nutrients. Peripheral venous disease, on the other hand, does not usually cause hair loss. Instead, it is characterized by symptoms related to venous insufficiency, such as varicose veins, swelling, and skin changes.
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