A patient who has a small cell carcinoma of the lung develops ...

[sabina]

A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should notify the health care provider about which assessment finding?
 
  a. Reported weight gain
  b. Serum hematocrit of 42
  c. Serum sodium level of 120 mg/dL
  d. Total urinary output of 280 mL during past 8 hours

Question 2

A patient is admitted for hypovolemia associated with multiple draining wounds. Which assessment would be the most accurate way for the nurse to evaluate fluid balance?
 
  a. Skin turgor
  b. Daily weight
  c. Presence of edema
  d. Hourly urine output

[olivia_paige29]

Answer to Question 1

ANS: C
Hyponatremia is the most important finding to report. SIADH causes water retention and a decrease in serum sodium level. Hyponatremia can cause confusion and other central nervous system effects. A critically low value likely needs to be treated. At least 30 mL/hr of urine output indicates adequate kidney function. The hematocrit level is normal. Weight gain is expected with SIADH because of water retention.

Answer to Question 2

ANS: B
Daily weight is the most easily obtained and accurate means of assessing volume status. Skin turgor varies considerably with age. Considerable excess fluid volume may be present before fluid moves into the interstitial space and causes edema. Although very important, hourly urine outputs do not take account of fluid intake or of fluid loss through insensible loss, sweating, or loss from the gastrointestinal tract or wounds.