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 C
Explanation
Choice A reason: Decreasing blood glucose levels are not an indicator of effective therapy in patients with acute adrenal insufficiency. In fact, hypoglycemia is a common symptom of Addison's Disease due to insufficient cortisol production, and effective therapy would aim to normalize blood glucose levels, not decrease them further.
Choice B reason: Increasing serum potassium levels would indicate worsening of the condition rather than improvement. Hyperkalemia is a hallmark of Addison's Disease due to aldosterone deficiency, and effective therapy should decrease serum potassium levels, not increase them.
Choice C reason: Increasing serum sodium levels would indicate that the therapy is effective for acute adrenal insufficiency. Addison's Disease is characterized by hyponatremia due to aldosterone deficiency, and effective treatment aims to normalize sodium levels in the blood. An increase in serum sodium levels indicates that the treatment is correcting the underlying electrolyte imbalance.
Choice D reason: Decreasing serum chloride levels are not a specific indicator of effective therapy for Addison's Disease. Chloride levels are generally less affected and not a primary marker for assessing treatment efficacy. The main focus should be on correcting sodium and potassium imbalances.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.