Which patient statement indicates to the nurse that further instruction is needed about chronic syndrome of inappropriate antidiuretic hormone (SIADH)?
"I need to shop for foods low in sodium and avoid adding salt to food."
"I need to limit my fluid intake."
"I should eat foods high in potassium because diuretics cause potassium loss."
"I should weigh myself daily and report sudden weight loss or gain."
Correct Answer : B,C
Choice A reason: "I need to shop for foods low in sodium and avoid adding salt to food." This statement is correct and indicates appropriate understanding. Patients with SIADH need to manage their sodium intake carefully to avoid exacerbating hyponatremia.
Choice B reason: "I need to limit my fluid intake." This statement indicates a misunderstanding. Patients with SIADH should actually increase their fluid intake to help dilute the excess antidiuretic hormone and reduce hyponatremia. Limiting fluid intake can worsen the condition.
Choice C reason: "I should eat foods high in potassium because diuretics cause potassium loss." This statement is incorrect in the context of SIADH. While potassium intake is important for patients on diuretics, it is not directly related to SIADH management. The focus should be on managing fluid and sodium levels.
Choice D reason: "I should weigh myself daily and report sudden weight loss or gain." This statement is correct and indicates appropriate understanding. Regular weight monitoring is important for patients with SIADH to detect fluid imbalances early.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A reason: Unilateral edema is a common sign of DVT. This occurs due to the obstruction of blood flow in the affected vein, leading to fluid buildup in the tissue, which causes swelling. The swelling is usually confined to the area of the leg where the clot is located, making it an important diagnostic indicator. In DVT, the affected limb often appears swollen compared to the other limb, and this can be easily observed by the healthcare provider during the physical examination.
Choice B reason: Nausea is not typically associated with DVT. While nausea can occur due to various medical conditions, it is not a primary symptom of DVT. DVT primarily affects the circulatory system, leading to symptoms related to impaired blood flow, such as swelling, pain, and redness in the affected limb. Therefore, nausea is unlikely to be directly related to the presence of a blood clot in the deep veins of the leg.
Choice C reason: Groin discomfort can be a symptom of DVT, especially if the clot is located in the femoral vein. The femoral vein runs through the groin area, and a clot in this vein can cause pain and tenderness in the groin. This discomfort is due to the pressure and inflammation caused by the clot obstructing blood flow. Patients may report a dull or aching pain in the groin, which can be exacerbated by movement or pressure.
Choice D reason: Calf pain is a classic symptom of DVT. It often presents as cramping, soreness, or aching in the calf due to the presence of a blood clot in the deep veins of the leg. The pain is caused by the increased pressure and inflammation in the affected vein, which irritates the surrounding tissues. This symptom is a key indicator of DVT and should prompt further evaluation and diagnostic testing, such as an ultrasound, to confirm the presence of a clot.
Correct Answer is B
Explanation
Choice A reason: Asking the patient why the wandering episodes have occurred might not be effective because patients with Alzheimer's disease often have memory and cognitive impairments that make it difficult for them to understand or articulate the reasons for their behavior. Additionally, it may not address the immediate safety concerns associated with wandering.
Choice B reason: Placing the patient in a room close to the nurse's station is a practical and effective measure to enhance patient safety. Proximity to the nurse's station allows for closer supervision and quicker response if the patient attempts to wander. This action helps prevent potential accidents and ensures that the patient receives timely interventions if needed. It is a proactive approach to managing the wandering behavior commonly seen in patients with Alzheimer's disease.
Choice C reason: Reorienting the patient several times daily is an important aspect of care for individuals with Alzheimer's disease, as it can help reduce confusion and anxiety. However, this alone may not be sufficient to prevent wandering. While reorientation is beneficial, the immediate safety of the patient requires additional measures, such as close supervision.
Choice D reason: Having the family bring in familiar items can provide comfort and a sense of security for the patient, which is important in managing Alzheimer's disease. Familiar objects may help reduce anxiety and agitation, but they do not directly address the safety concerns associated with wandering. This action should be part of a comprehensive care plan that includes measures to prevent wandering and ensure patient safety.
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