The nurse cares for clients in the outpatient clinic. Which client is MOST at risk for the syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

Choice A reason: Diarrhea is less common in acute pancreatitis, which typically causes nausea and vomiting. Flank discoloration is a specific sign, making this incorrect, as it’s not a primary finding the nurse would expect in the assessment of acute pancreatitis.

Choice B reason: Black tarry stools indicate upper GI bleeding, not pancreatitis, which causes pain and guarding. Left quadrant pain is typical, making this incorrect, as it’s unrelated to the nurse’s expected findings in a client with suspected acute pancreatitis.

Choice C reason: Hyperactive bowel sounds suggest obstruction, not pancreatitis, which often causes hypoactive sounds due to inflammation. Abdominal tenderness is correct, making this incorrect, as it doesn’t align with the nurse’s anticipated findings in acute pancreatitis assessment.

Choice D reason: Gray, including its reasoning, and a gray-blue flank (Cullen’s or Grey Turner’s sign) indicates severe pancreatitis with hemorrhage. This aligns with severe pancreatitis assessment, making it a correct finding the nurse would expect in suspected acute pancreatitis.

Choice E reason: Abdominal guarding and tenderness result from pancreatic inflammation, common in acute pancreatitis. This aligns with abdominal assessment findings, making it a correct manifestation the nurse would identify in a client with suspected acute pancreatitis.

Choice F reason: Left upper quadrant pain radiating to the back is classic in acute pancreatitis due to pancreatic inflammation. This aligns with clinical assessment, making it a correct finding the nurse would expect in a client with suspected acute pancreatitis.

Choice A reason: Restricting fluids is contraindicated in burns, as hypovolemia requires aggressive fluid resuscitation. Administering lactated Ringer’s is correct, making this incorrect, as it’s unsafe compared to the nurse’s priority to restore volume in a burn-injured client.

Choice B reason: Dextrose 5% is not used for burn resuscitation, as it lacks electrolytes needed for fluid shifts. Lactated Ringer’s is standard, making this incorrect, as it’s inappropriate compared to the nurse’s focus on proper fluid therapy for burn management.

Choice C reason: Administering oxygen addresses potential airway compromise and hypoxia from facial and chest burns. This aligns with burn care priorities, making it a correct action the nurse would implement to ensure respiratory stability in the emergency department.

Choice D reason: A cooling blanket is not standard for partial-thickness burns; cooling is brief and initial. Elevating extremities reduces edema, making this incorrect, as it’s not a priority action compared to the nurse’s focus on burn injury management.

Choice E reason: Elevating extremities without fractures reduces edema in burned arms, improving circulation. This aligns with burn care protocols, making it a correct action the nurse would implement to manage swelling in the client with partial-thickness burns.

Choice F reason: Oral pain medication is contraindicated with facial burns due to airway risks and absorption issues. IV lactated Ringer’s is appropriate, making this incorrect, as it’s unsafe compared to the nurse’s priority for pain management in burns.

Choice G reason: Administering lactated Ringer’s 1 L bolus restores fluid volume in burn-induced hypovolemia, per resuscitation protocols. This is a correct action the nurse would implement to stabilize the client with partial-thickness burns in the emergency department.