Hyponatremia is a common fluid and electrolyte disturbance in adults with cancer. Although a number of etiologies are associated with hyponatremia, the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is one of the most common underlying causes. Early symptoms often associated with SIADH are subtle but, if left untreated, may progress to life-threatening seizures, coma, and death. Because oncology nurses have frequent and ongoing contact with patients, they are in an ideal position to recognize patients who are at increased risk for SIADH and those who present with early symptoms. Beginning signs and symptoms are mild and can be mistakenly attributed to other causes. This article reviews the pathophysiology of SIADH, associated risk factors, signs and symptoms, diagnosis, treatment, and nursing care. Show
Not a current ONS member or journal subscriber? Receive a PDF to download and print.  Detailed Answer Key Endocrine 3 1.A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? A. "I will carry a complex carbohydrate snack with me when I exercise." Rationale:The nurse should reinforce that the client should carry a simple carbohydrate such as hard candy or glucose tablets for use during exercise if the client becomes hypoglycemic. B. "I should exercise first thing in the morning before eating breakfast." Rationale:The nurse should reinforce that exercise should follow a meal. Exercising first thing in the morning on an empty stomach places the client at risk for hypoglycemia. C. "I should avoid injecting insulin into my thigh if I am going to go running." Rationale:The nurse should reinforce that the client should avoid injecting insulin into an area that will soon be exercised to avoid increasing the absorption rate of the insulin. D. "I will increase the intensity of my exercise routine if my urine is positive for ketones." Rationale:The nurse should reinforce that exercise should be avoided if ketones are present in the urine as this indicates an elevated blood glucose level or ketoacidosis. 2.A nurse is caring for a client who has Cushing's syndrome. Which of the following clinical manifestations should the nurse expect to observe? (Select all that apply.) A. Buffalo hump B. Purple striations C. Moon face D. Tremors E. Obese extremities Rationale:Buffalo hump is correct. Cushing's syndrome is a disease caused by an increased production of cortisol or by excessive use of corticosteroids. Buffalo hump, a collection of fat between the shoulders, is a common manifestation of Cushing's syndrome. Purple striations is correct. Purple striations on the skin of the abdomen, thighs, and breasts are a common manifestation of Cushing's syndrome. This is due to the collection of body fat in these areas. Moon face is correct. Moon face is a common manifestation of Cushing's syndrome. Clients who have this manifestation present with a round, red, full face. Tremors is incorrect. Tremors are not a common finding of Cushing's syndrome. Obese extremities is incorrect. Clients who have Cushing's syndrome have truncal obesity, a protuberant abdomen, with thin extremities, which is due to an alteration in protein metabolism. Created on:03/31/2021Page 1 A nurse is planning preoperative care for a client who has pheochromocytoma. What's priority? Avoid palpating the abdomen. A home health nurse is assessing a client who is on lifelong hormone replacement.
He's not taking it regularly. What does the nurse expect? A nurse is caring for a client following a thyroidectomy. The nurse should assess for what? Tingling and numbness of the hands and feet. A nurse is caring for a client who has diabetes mellitus
and developed peripheral neuropathy. How does he prevent injuries to his feet? Monitor the temperature of bath water with a thermometer. A nurse is preparing insulin for a client who has diabetes mellitus. How do you administer these two meds safely? (insulin glargine and regular insulin) Draw up the insulin glargine and the regular insulin into separate syringes. A nurse is caring for a client who is taking propylthiouracil (PTU). Nurse expects an increase in A nurse is assessing a client who has a new diagnosis of Cushing's disease. What's expected? A
nurse is developing a teaching plan for a client who has a thyroidectomy and takes a thyroid hormone. What do they teach? "Take this medication on an empty stomach" A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. What is accurate about this test? "This
test is a good indicator of my average blood glucose levels." A nurse is providing teaching for a client who has diabetes mellitus. What should be included? Blood glucose levels greater than 300 mg/dL A nurse is assessing a client who has diabetes insipidus. The nurse should
expect A nurse is planning dietary teaching for a client who has type 1 diabetes mellitus. What should the nurse teach about alcohol consumption? Ingest alcohol with meals to reduce alcohol-induced hypoglycemia A nurse is admitting a client who has hyperthyroidism. When
assessing the client, what's expected? A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. What shows he understands? "I will apply lotion to the dry areas of my feet, avoiding application between my toes." A nurse is assessing a
client who has diabetes mellitus and reports feeling anxious. What is a symptom of hypoglycemia? A nurse is preparing to administer propranolol by IV bolus to a client experiencing a thyroid storm. What shows a therapeutic response? Reduction of the effects of thyroid hormone on the heart. A nurse is monitoring the lab values of a client who has diabetes mellitus and which is an outcome of insulin therapy? Fasting blood glucose 96 mg/dL A nurse is providing teaching for a client who has type 1 diabetes mellitus. Which statements indicates that the client understands the
teaching? "I will call my doctor if my blood sugar is more than 250 mg/dL" A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following finding should the nurse expect? A nurse is preparing to give a client information about an adrenocorticotropic hormone (ACTH). It's to assess
which of the following disorders? A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription. What instructions should the nurse include? Blow nose gently prior to using the nasal spray A nurse is caring for a client undergoing
screening for primary Cushing's diease. The nurse should expect what lab to be elevated? The nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteriod therapy. -Osteoporosis A nurse is managing the care of a client who is postoperative and experiencing acute adrenal insufficiency. Administer IV hydrocortisone sodium succinate. A nurse is performing an assessment on a client who has syndrome of inappropriate antidiuretic hormone (SIADH). What should the nurse report? A nurse is assessing a client who has adrenal insufficiency. A nurse is reviewing lab values for a client who has diabetic ketoacidosis (DKA). pH: 7.32 To screen a client
for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test. What instructions should the nurse include? Restrict coffee intake 2-3 days prior to the test. A nurse is caring for a client who has type 2 diabetes mellitus and is admitted with hyperglycemia hyperosmolar state (HHS). Which of
the following lab findings should the nurse expect? Blood glucose of 846 mg/dL and serum pH of 7.40 A nurse is preparing a teaching plan for a client who has diabetes insipidus and is receiving intranasal desmopression. What should the nurse include? Occurrence of nocturia
indicates the need for a dosage adjustment. What intervention should be done for a patient with syndrome of inappropriate antidiuretic hormone?The most commonly prescribed treatment for SIADH is fluid and water restriction. If the condition is chronic, fluid restriction may need to be permanent. Treatment may also include: Certain medications that inhibit the action of ADH (also called vasopressin)
What of the following is found in the syndrome of inappropriate antidiuretic hormone?With SIADH, the urine is very concentrated. Not enough water is excreted and there is too much water in the blood. This dilutes many substances in the blood such as sodium. A low blood sodium level is the most common cause of symptoms of too much ADH.
What medication that is appropriate for SIADH patient?Immediate treatment of the symptomatic patient with SIADH includes intravenous furosemide and 3% sodium chloride injection to produce a negative free-water balance. If the underlying cause of SIADH cannot be corrected, the treatment of choice for chronic SIADH is fluid restriction.
Which interventions would the nurse implement when caring for a client with SIADH?Interventions for clients who are diagnosed with SIADH include daily weights, restriction of fluid intake, documentation of intake and output, administration of salt tablets by mouth, and the administration of 3% saline.
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A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone
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