A 26-year-old male patient with a diagnosis of schizophrenia has ...

[jerry coleman]

A 26-year-old male patient with a diagnosis of schizophrenia has been admitted with suspected hyponatremia after consuming copious quantities of tap water.
 
  Given this diagnosis, what clinical manifestations and lab results should the nurse anticipate the patient will exhibit?
  A)
  High urine specific gravity, tachycardia, and a weak, thready pulse
  B)
  Low blood pressure, dry mouth, and increased urine osmolality
  C)
  Increased hematocrit and blood urea nitrogen and seizures
  D)
  Muscle weakness, lethargy, and headaches.

Question 2

The nurse is caring for a patient with ketoacidosis, who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet.
 
  The nurse understands which of the following phenomena is most likely occurring?
  A)
  High-fat, low-carbohydrate dietary intake is associated with respiratory acidosis.
  B)
  In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids.
  C)
  Metabolism of dietary fats without the buffer action of carbohydrates results in the catabolism of ketoacids.
  D)
  Decreased carbohydrate intake induces insulin deficiency and consequent ketoacidosis.

[gcook]

Answer to Question 1

Ans:
D

Feedback:

Weakness, lethargy, and nausea are noted manifestations of hyponatremia. High urine specific gravity, tachycardia, and a weak, thread pulse are associated with hypernatremia, while low blood pressure, fever, and increased urine osmolality are manifestations of fluid volume deficit. Increased hematocrit and blood urea nitrogen and seizures are also associated with hypernatremia.

Answer to Question 2

Ans:
B

Feedback:

Low-carbohydrate diets can induce the fat metabolism and consequent metabolic acidosis that is more commonly associated with diabetic ketoacidosis. The acidotic state is not classified as respiratory in nature and does not involve a buffer role for carbohydrates or insulin deficiency.