A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

Correct Answer: D

Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is an excessive release of antidiuretic hormone (ADH), leading to water retention by the kidneys and dilution of electrolytes in the blood. This can result in hyponatremia and fluid overload. Therefore, the appropriate nursing intervention for a client with SIADH is to restrict fluids to help prevent further fluid retention and worsening of hyponatremia. Infusing IV fluids rapidly, administering glucose-containing IV fluids, or encouraging increased oral fluid intake would exacerbate the problem by further diluting the electrolyte concentration in the blood. By restricting fluids, the aim is to maintain a strict intake and output balance to promote a gradual increase in serum sodium levels and help restore normal fluid balance in the body.

Correct Answer: B

Rationale: After a right lower lobectomy, it is important to keep the patient in a semi-Fowler's position to promote lung expansion and oxygenation. This position helps to reduce pressure on the diaphragm and allows for better lung ventilation. By maintaining the patient in a semi-Fowler's position, it can help prevent complications such as atelectasis and pneumonia postoperatively. It is a crucial nursing intervention to ensure optimal respiratory function and promote recovery after lung surgery.

Correct Answer: B

Rationale: In the scenario of an elderly patient like Mr. Cruz with suspected pulmonary embolism, the nurse would anticipate an order for the immediate administration of heparin. Heparin is an anticoagulant medication that works quickly to prevent the further development of blood clots. It is often used as the initial treatment for pulmonary embolism to prevent existing blood clots from getting larger and reduce the risk of new clots forming. Heparin is preferred over warfarin initially because it has a more rapid onset of action. Warfarin, which is a commonly used anticoagulant for longer-term management, takes several days to reach its full effect and requires monitoring of the prothrombin time (INR). Therefore, in Mr. Cruz's acute situation, heparin would be the most appropriate choice for immediate intervention to address the pulmonary embolism.

Correct Answer: C

Rationale: Romberg's test is a neurological test that assesses the function of the dorsal columns of the spinal cord, which are responsible for proprioception and vibration sensations. A lumbar injury can affect these dorsal columns, leading to impaired proprioception. Therefore, the Romberg's test would be affected due to the compromised sensory input from the lower extremities. This test usually involves asking the patient to stand with feet together and eyes closed to assess balance and proprioception.

Correct Answer: B

Rationale: Raynaud's disease is a condition characterized by vasospasms of the small arteries, usually in the fingers and toes, in response to cold temperatures or stress. Smoking can worsen the symptoms of Raynaud's disease because it causes vasoconstriction, which is the narrowing of blood vessels. Nicotine in cigarettes can trigger vasospasms, leading to further restriction of blood flow to the extremities. Therefore, it is essential for individuals with Raynaud's disease to stop smoking to help improve blood circulation and reduce the frequency and severity of vasospasms.