In reviewing admission orders for a patient admitted with SIADH, the nurse should question which order?

IV 3% NS at 10 mL/hr

Seizure precautions

Fluid restriction of 1000 mL/day

Sodium-restricted diet

Answer and Explanation

The Correct Answer is A

A. In SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion), the body retains excessive water, leading to dilutional hyponatremia (low sodium levels). Administering hypertonic saline (3% NS) can exacerbate the condition by rapidly increasing sodium levels, which may cause demyelination of neurons (a condition called osmotic demyelination syndrome). Hypertonic saline is typically only used in severe hyponatremia with neurologic symptoms and should be carefully monitored.
B. Seizure precautions are appropriate in SIADH due to the risk of seizures from severe hyponatremia, which can lead to cerebral edema and neurological compromise.
C. Fluid restriction of 1000 mL/day is appropriate in SIADH to manage the dilutional hyponatremia by preventing further fluid retention.
D. A sodium-restricted diet is also recommended in SIADH to avoid further dilution of sodium levels and prevent worsening of hyponatremia.

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Correct Answer is ["B","C","E"]

Explanation

A. Polyuria is typically a symptom of hyperglycemia (high blood sugar) rather than hypoglycemia. When blood glucose is elevated, the kidneys attempt to excrete the excess glucose, leading to increased urination.
B. Tachycardia (increased heart rate) is a common sign of hypoglycemia due to the body's stress response to low blood sugar. The release of adrenaline (epinephrine) can cause a rapid heart rate.
C. Blurred vision can occur with hypoglycemia because low glucose levels can affect the function of the retina and cause vision changes. This can resolve once the blood glucose level is normalized.
D. Polydipsia (excessive thirst) is more commonly seen in hyperglycemia, as high blood glucose leads to dehydration due to increased urination.
E. Moist, clammy skin is a classic sign of hypoglycemia. When blood sugar drops too low, the body activates the sympathetic nervous system, which can cause sweating and clammy skin.

A. Peak flow of more than 40% B. Bradycardia C. Loud and prominent wheezing D. Arterial blood gas is deteriorating

Correct Answer is D

Explanation

A. A peak flow of more than 40% would indicate that the patient's asthma is not in an acute exacerbation. This patient's symptoms, such as confusion and inability to speak, suggest a severe asthma attack, and the peak flow would likely be much lower.
B. Bradycardia is not typically associated with severe asthma exacerbations. Tachycardia is more commonly observed as the body attempts to compensate for hypoxia.
C. Loud and prominent wheezing is usually seen in less severe cases of asthma. In this case, the inability to speak and confusion suggest severe respiratory distress, where wheezing might be diminished or absent due to poor air movement.
D. Deteriorating arterial blood gas (ABG) results, with low oxygen levels (hypoxemia) and elevated carbon dioxide levels (hypercapnia), would be expected in a patient with severe asthma exacerbation. These signs indicate respiratory failure and the need for urgent intervention.

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In reviewing admission orders for a patient admitted with SIADH, the nurse should question which order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

A patient with asthma is admitted with severe dyspnea and is unable to speak. The nurse finds that the patient looks drowsy and confused. Which other finding would the nurse expect?

Correct Answer is D

Explanation

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