Nokea
. A client is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result?
- A. Decreased serum sodium level
- B. Increased blood urea nitrogen
- C. Decreased serum creatinine level (BUN) level
- D. Increased hematocrit
Correct Answer: A
Rationale: A client with the syndrome of inappropriate antidiuretic hormone (SIADH) retains water excessively due to overproduction of antidiuretic hormone (ADH). This leads to dilutional hyponatremia, resulting in decreased serum sodium levels. Hyponatremia is a hallmark laboratory finding in patients with SIADH. Other laboratory values you might see in SIADH include decreased serum osmolality, concentrated urine with a high sodium concentration, and normal renal function tests such as BUN and creatinine. Therefore, the most anticipated laboratory test result in a client with SIADH is a decreased serum sodium level.
You may also like to solve these questions
A client who suffered a vehicular accident a few days ago is in skeletal traction. Which nursing action would BESt promote INDEPENDENCE for this patient?
- A. tell the client to call for an analgesic before the pain felt becomes severe
- B. encourage the patient to do leg exercises within the limits of his traction
- C. provide an overhead trapeze for client use on the Balkan frame
- D. provide skin care to prevent skin breakdown
Correct Answer: B
Rationale: Encouraging the patient to do leg exercises within the limits of his skeletal traction is the best nursing action to promote independence for the client. By engaging in leg exercises, the patient can maintain muscle strength and joint flexibility, which can prevent complications such as muscle atrophy and joint stiffness. This activity empowers the client to actively participate in their own care and promotes a sense of independence and control over their health during a period of immobility. Additionally, it can help improve circulation and prevent complications related to immobility such as deep vein thrombosis.
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. How should the nurse interpret this finding?
- A. Normal finding
- B. Finding requiring a referral
- C. Abnormal finding
- D. Normal finding, but requires rechecking in 1 month
Correct Answer: A
Rationale: The closure of the anterior fontanel in a 14-month-old infant is a normal finding. The anterior fontanel typically closes by around 18 months of age. The closure of the fontanel is a sign of normal growth and development as the bones of the skull fuse together. It is not a cause for concern at this age, and the nurse should document this as a normal finding.
A chest radiograph film is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the radiograph show about the heart?" What knowledge about the x-ray should the nurse include in the response to the parents?
- A. Bones of chest but not the heart
- B. Measurement of electrical potential generated from heart muscle
- C. Permanent record of heart size and configuration
- D. Computerized image of heart vessels and tissues
Correct Answer: C
Rationale: A chest radiograph film, commonly known as a chest X-ray, shows a permanent record of the size and configuration of the heart. It can provide information about the overall size and shape of the heart, the presence of any abnormalities (such as an enlarged heart), and the position of the heart within the chest cavity. While a chest X-ray can also show the bones of the chest, it is primarily used to visualize the heart and lungs. It does not measure electrical potential generated from heart muscle (which would be seen on an ECG) or show a computerized image of heart vessels and tissues (which would typically require more advanced imaging techniques such as a CT scan or MRI).
A 62-year old client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past 2 years. She's fatigued from lack of sleep; urinates frequently, even during the night, and has lost weight recently. Tests reveal the following: sodium level 152mEq/L, osmolarity 340mOsm/L, glucose level 125mg/dl, and potassium level of 3.8mEq/L. Which of the following nursing diagnoses is most appropriate for this client?
- A. Deficient fluid volume related to inability to conserve water
- B. Imbalanced nutrition: Less than body requirements related to hypermetabolic state
- C. Deficient fluid volume related to osmotic diuresis induced by hypernatremia
- D. Imbalanced nutrition: Less than body requirements related to catabolic effects of insulin deficiency
Correct Answer: C
Rationale: The client's elevated sodium level of 152 mEq/L indicates hypernatremia, which can lead to osmotic diuresis, causing excessive urination and subsequent fluid loss. This fluid loss can result in deficient fluid volume. The client's symptoms of frequent urination, fatigue from lack of sleep, and weight loss are indicative of dehydration due to the osmotic diuresis. Therefore, the most appropriate nursing diagnosis for this client is Deficient fluid volume related to osmotic diuresis induced by hypernatremia.
What should be included in the plan of care for a preschool-age child who is admitted in a vasoocclusive sickle cell crisis (pain episode)?
- A. Pain management
- B. Administration of heparin
- C. Factor VIII replacement
- D. Electrolyte replacement
Correct Answer: A
Rationale: Pain management is a crucial component in the plan of care for a preschool-age child admitted with a vasoocclusive sickle cell crisis. Sickle cell disease causes blood vessels to become blocked, leading to ischemia and pain. Managing pain promptly and effectively is necessary to improve the child's comfort level and prevent complications. Pain management strategies typically involve the use of analgesic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, tailored to the child's age and weight. Additionally, non-pharmacological interventions like distraction techniques and positioning can help in reducing pain and promoting relaxation in children during a sickle cell crisis.