The nurse understands which of the following actions is an effective treatment approach for SIADH?
Administering diuretics to promote diuresis and eliminate excess fluid.
Increasing fluid intake to promote dilution of electrolytes.
Restricting fluid intake to prevent fluid overload.
Administering hypertonic 3% saline to restore electrolyte balance.
Correct Answer : C,D
Choice A rationale
Administering diuretics in SIADH can worsen hyponatremia by promoting water excretion with a concomitant loss of sodium, further diluting serum sodium concentration. The underlying issue in SIADH is excessive antidiuretic hormone leading to water retention, not primarily excess extracellular fluid that needs diuresis.
Choice B rationale
Increasing fluid intake is contraindicated in SIADH. The syndrome involves excessive reabsorption of water, leading to dilutional hyponatremia and fluid overload. Increasing fluid intake would exacerbate these issues, further lowering serum sodium levels and potentially leading to cerebral edema.
Choice C rationale
Restricting fluid intake is a cornerstone of SIADH management. By limiting water intake, the body's excessive water retention is mitigated, allowing serum sodium concentration to rise towards normal levels. This helps prevent further dilution of electrolytes and reduces the risk of fluid overload and cerebral edema.
Choice D rationale
Administering hypertonic 3% saline is an effective treatment for symptomatic severe hyponatremia in SIADH. This solution provides a concentrated source of sodium, helping to raise serum sodium levels by drawing water out of cells and into the extracellular space, thereby correcting the dilutional hyponatremia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","H"]
Explanation
Signs: "increasingly confused and irritable", "tremors in the client's hands when arms are extended", "The client with cirrhosis appears disoriented and has difficulty answering simple asks", "The nurse observes asterixis when the client extends their arms", "The nurse monitors the client closely for worsening neurologic functions.”. Causes: "cirrhosis", "elevated mental status" (This phrase is likely a typo and should refer to elevated ammonia levels, which is the primary cause of hepatic encephalopathy). Treatments: "The provider prescribes lactulose to lower ammonia levels.”.
Correct Answer is A
Explanation
Choice A rationale
Confronting bullying behavior directly establishes clear professional boundaries and expectations within the unit. This approach fosters a psychologically safe environment, which is crucial for team cohesion and optimal patient care. Addressing the issue promptly prevents escalation and demonstrates leadership commitment to a respectful workplace, promoting accountability and encouraging healthier communication patterns among staff.
Choice B rationale
Modeling bullying behavior is counterproductive and unethical, as it normalizes and perpetuates harmful actions within the workplace. Such actions undermine trust, decrease morale, and can lead to increased stress, burnout, and higher staff turnover rates. A nurse manager's role is to promote a positive and supportive work environment, not to emulate detrimental behaviors.
Choice C rationale
Ignoring horizontal violence, even if not physical, can have significant negative psychological and professional consequences for staff members and the unit. Verbal abuse and gossip erode trust, create a toxic work environment, and can lead to increased anxiety, depression, and decreased job satisfaction, ultimately impacting patient care quality.
Choice D rationale
While logging observed behavior is a useful documentation tool, waiting for an annual evaluation to address horizontal violence delays necessary intervention. Prompt and direct confrontation is essential to mitigate immediate harm and prevent further escalation. Addressing the issue in a timely manner demonstrates a commitment to a safe workplace and supports a healthy team dynamic.
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