A patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would the nurse expect?
Increased serum chloride
Elevated hematocrit
Decreased serum sodium
Low urine specific gravity
The Correct Answer is C
Choice A reason: Increased serum chloride is not a typical finding associated with syndrome of inappropriate antidiuretic hormone (SIADH). In SIADH, the body's regulation of water is impaired, leading to water retention and dilutional hyponatremia. Serum chloride levels might not be significantly affected and are not the primary laboratory indicator for this condition.
Choice B reason: Elevated hematocrit is not directly related to SIADH. Hematocrit levels reflect the proportion of red blood cells in the blood. In SIADH, the main issue is water retention leading to dilutional hyponatremia, rather than changes in red blood cell concentration. Therefore, hematocrit levels are not a key laboratory finding in this disorder.
Choice C reason: Decreased serum sodium, or hyponatremia, is a hallmark finding in SIADH. The excessive release of antidiuretic hormone (ADH) leads to water retention, diluting the sodium in the blood and resulting in low serum sodium levels. This hyponatremia can cause symptoms such as disorientation, headache, and muscle cramps, as seen in the patient. Monitoring and correcting serum sodium levels is crucial in the management of SIADH.
Choice D reason: Low urine specific gravity is not expected in SIADH. In fact, patients with SIADH typically have a high urine specific gravity due to the excessive release of ADH, which causes the kidneys to reabsorb water and concentrate the urine. This concentrated urine reflects the body's attempt to reduce water excretion in response to elevated ADH levels. Therefore, low urine specific gravity would not be an initial laboratory finding in this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cardiac dysrhythmias are not the primary concern in a patient with acute cholecystitis. Although severe pain can lead to stress on the cardiovascular system, it is not the main priority in this scenario. Hypotension can be a concern due to dehydration from vomiting, but pain management is addressed more comprehensively under fluid and electrolyte balance and infection control.
Choice B reason: Wound dehiscence is not relevant in this case as the patient has not undergone surgery yet. Fluid and electrolyte imbalance and hypotension are important considerations due to the patient’s nausea and vomiting, but wound dehiscence does not apply to her current state of care.
Choice C reason: The inadequate diet is a consideration due to the patient's inability to eat or drink, and hypotension is a risk due to dehydration. However, wound dehiscence is still not relevant since the patient has not had a surgical procedure yet. Preventing an inadequate diet is part of the broader management but not the immediate priority.
Choice D reason: Infection, fluid and electrolyte imbalance, and pain are the most relevant concerns for a patient with acute cholecystitis. The nasogastric tube and IV fluids are vital for managing her dehydration and electrolyte imbalances. The patient's high pain level (9/10) indicates severe discomfort that must be managed effectively. Additionally, with the insertion of a nasogastric tube and the risk of cholecystitis-related complications, preventing infection is a key priority.
Correct Answer is B
Explanation
Choice A reason: Monitoring potassium levels is essential for various medical conditions, but it is not specifically used to evaluate the effects of therapy for acute pancreatitis. Potassium levels may be monitored to assess overall electrolyte balance and kidney function, but they do not provide direct information about pancreatic inflammation or damage.
Choice B reason: Monitoring lipase levels is crucial in evaluating the effects of therapy for a patient with acute pancreatitis. Lipase is an enzyme produced by the pancreas, and its levels rise significantly during an acute episode of pancreatitis. Elevated lipase levels are a sensitive and specific indicator of pancreatic inflammation and damage. By regularly measuring lipase levels, healthcare providers can assess the severity of the condition, monitor the patient's response to treatment, and make necessary adjustments to the therapeutic regimen.
Choice C reason: Calcium levels are not typically used to evaluate the effects of therapy for acute pancreatitis. Although hypercalcemia (high calcium levels) can be a risk factor for developing pancreatitis, monitoring calcium levels is not a standard method for assessing the effectiveness of treatment for the condition.
Choice D reason: Bilirubin levels are not directly related to the evaluation of therapy for acute pancreatitis. Bilirubin is a breakdown product of hemoglobin and is primarily used to assess liver function and diagnose conditions such as jaundice or liver disease. While liver function tests may be performed in patients with pancreatitis to rule out concurrent liver issues, bilirubin levels alone do not provide information about the effectiveness of therapy for pancreatitis.
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