Which patient statement indicates to the nurse that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)?
"I should eat foods high in potassium because diuretics cause potassium loss."
"I need to limit my fluid intake to no more than 1 quart of liquids a day."
"I need to shop for foods low in sodium and avoid adding salt to food."
"I should weigh myself daily and report sudden weight loss or gain."
The Correct Answer is C
Choice A reason: Eating foods high in potassium can be important for patients taking diuretics, as diuretics can cause potassium loss. However, for SIADH patients, this is not a primary focus unless they are on diuretics that specifically lead to potassium loss.
Choice B reason: Limiting fluid intake is crucial for patients with SIADH to prevent fluid overload and hyponatremia. This statement aligns with proper management of the condition.
Choice C reason: Patients with SIADH need to carefully manage their sodium intake. Rather than reducing sodium, they often need to maintain or increase their sodium intake to help counteract the effects of SIADH, which causes dilutional hyponatremia (low blood sodium levels). Therefore, this statement indicates a need for additional instruction.
Choice D reason: Weighing oneself daily is an important practice for SIADH patients to monitor for sudden weight changes, which can indicate fluid imbalances. This statement is appropriate and does not require additional instruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D,A,B,C
Explanation
Choice D reason: Elevating the head of the bed to 45 degrees is the first intervention the nurse should perform. This position helps lower the patient's blood pressure by promoting venous pooling in the lower extremities and reducing the return of blood to the heart. It also aids in better breathing and overall comfort.
Choice A reason: Checking the blood pressure is crucial in this situation to confirm if the patient is experiencing autonomic dysreflexia, which is characterized by a sudden and severe increase in blood pressure. This step helps in assessing the severity of the condition and guiding subsequent interventions.
Choice B reason: Obtaining a bladder scan is important because a full bladder is a common trigger of autonomic dysreflexia. By identifying and addressing the cause of the distension, the nurse can help alleviate the symptoms and prevent further complications.
Choice C reason: Notifying the doctor is a critical step, as autonomic dysreflexia is a medical emergency that requires prompt medical intervention. The healthcare provider can give additional orders and may administer medication to control the patient's blood pressure and relieve symptoms.
Correct Answer is A
Explanation
Choice A reason: Administering antiemetics before chemotherapy is an effective intervention to help manage Sarah's nausea. Antiemetics can prevent or reduce the severity of nausea and vomiting associated with chemotherapy, making it easier for patients to tolerate treatment and maintain their nutritional status.
Choice B reason: Encouraging carbonated beverages is not a recommended intervention for managing nausea. Carbonated beverages can sometimes worsen nausea due to their acidity and carbonation.
Choice C reason: Recommending three large meals and two small snacks daily is not the best approach for managing nausea. Smaller, more frequent meals are generally more effective in preventing nausea and ensuring adequate calorie intake. Large meals can be overwhelming and may exacerbate nausea.
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