The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?
Serum potassium 5.0 mEq/L
Serum calcium 8.0 mg/dL
Serum sodium 125 mEq/L
Blood urea nitrogen (BUN) 24 mg/dL
The Correct Answer is C
Choice A reason:
A serum potassium level of 5.0 mEq/L is within the normal range (3.5-5.0 mEq/L). While it is on the higher end of normal, it does not require immediate intervention in the context of SIADH. Potassium levels are crucial for cardiac and muscle function, but this value does not indicate a critical imbalance.
Choice B reason:
A serum calcium level of 8.0 mg/dL is slightly below the normal range (8.5-10.2 mg/dL). Mild hypocalcemia can occur in various conditions, but it is not typically associated with SIADH and does not require immediate intervention unless symptomatic or significantly lower.
Choice C reason:
A serum sodium level of 125 mEq/L indicates hyponatremia, which is a hallmark of SIADH. Hyponatremia can lead to severe neurological symptoms, including seizures, confusion, and coma, especially if it develops rapidly. Immediate intervention is required to correct the sodium imbalance and prevent serious complications.
Choice D reason:
A blood urea nitrogen (BUN) level of 24 mg/dL is within the upper normal range (7-20 mg/dL). While slightly elevated, it is not critically high and does not require immediate intervention in the context of SIADH. BUN levels can be influenced by various factors, including hydration status and renal function.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Injections in the thigh are absorbed more slowly compared to the abdomen. The thigh is a common site for insulin injections, but it does not provide the fastest absorption rate. The absorption rate can be influenced by physical activity, as exercise can increase blood flow to the muscles, potentially speeding up insulin absorption. However, under normal conditions, the thigh is not the fastest site for insulin absorption.
Choice B reason:
Injections in the upper arm have a moderate absorption rate. The upper arm is another common site for insulin injections, but it is not the fastest. The absorption rate from the upper arm is generally faster than the thigh but slower than the abdomen. This site can be convenient for injections, especially for those who find it difficult to reach other areas.
Choice C reason:
Injections in the buttocks have the slowest absorption rate among the common injection sites. The buttocks are less commonly used for insulin injections due to the slower absorption rate and the difficulty some individuals may have in administering injections in this area. The high fat content in the buttocks slows down the absorption of insulin.
Choice D reason:
Injections in the abdomen provide the fastest absorption rate for insulin. The abdomen is the preferred site for many people with diabetes because it has a large surface area and is easy to access. The insulin injected into the abdominal area is absorbed quickly into the bloodstream, making it the most effective site for rapid-acting insulin. This is particularly important for managing blood sugar levels around meal times.
Correct Answer is C
Explanation
Choice A reason:
A client admitted for hip fracture surgery is at risk for various complications, but not specifically for hyperosmolar hyperglycemic syndrome (HHS). HHS is more commonly triggered by infections, severe dehydration, or other acute illnesses. While surgery can be a stressor, it is not as directly linked to HHS as infections are.
Choice B reason:
A client who is awaiting cataract surgery is not typically at high risk for developing HHS. Cataract surgery is generally a planned and controlled procedure that does not usually involve the acute stressors or infections that can precipitate HHS.
Choice C reason:
A client who is receiving an antibiotic for a urinary tract infection is at a higher risk for developing HHS. Infections are a common precipitating factor for HHS because they can cause significant stress on the body, leading to elevated blood glucose levels. The body’s response to infection can exacerbate hyperglycemia, especially in individuals with type 2 diabetes.
Choice D reason:
A client who is being evaluated for a breast lump is not typically at high risk for HHS. While the evaluation process can be stressful, it does not usually involve the acute physiological stressors or infections that are more directly linked to the development of HHS.
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