A nurse is administering Lasix to a client with SIADH. The ...

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A nurse is administering Lasix to a client with SIADH. The desired outcome would be:
 
  1. a decrease in serum potassium.
  2. an increase in blood pressure.
  3. a decrease in serum osmolality.
  4. an increase in urine output.

Question 2

A nurse is administering desmopressin to a client recovering from a head injury that increased pressure on the posterior pituitary gland.
 
  The nurse recognizes that this form of artificial antidiuretic hormone (ADH) will have the most impact on which portion of the assessment?
  1. Peripheral nervous system function, including reflexes
  2. Cardiac function, including the conduction system
  3. Urine output and blood pressure
  4. The Glasgow coma scale

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Answer to Question 1

Correct Answer: 4
Rationale 1: Lasix is not given to this client to reduce the serum potassium level.
Rationale 2: Lasix is not given to this client to increase blood pressure.
Rationale 3: The client already has a low serum osmolality because of SIADH.
Rationale 4: SIADH is accompanied by low urine output and low serum osmolality. The goal of diuretic therapy is to eliminate water from the body. Urine output will increase. Loss of fluid from the vascular tree will thicken the serum, so serum osmolality will increase.
Global Rationale: SIADH is accompanied by low urine output and low serum osmolality. The goal of diuretic therapy is to eliminate water from the body. Urine output will increase. Loss of fluid from the vascular tree will thicken the serum, so serum osmolality will increase. Potassium loss is not the goal of therapy and blood pressure is more likely to drop as fluid is excreted. The client already has a low serum osmolality because of SIADH.

Answer to Question 2

Correct Answer: 3
Rationale 1: ADH does not impact the peripheral nervous system or reflexes.
Rationale 2: The conduction system is not affected, although heart rate speeds up in response to volume loss, and the blood pressure drops if the loss is extreme.
Rationale 3: ADH is essential to fluid balance. Lack of ADH causes a condition called diabetes insipidus. Untreated ADH results in death from shock.
Rationale 4: ADH does not directly affect the client's Glasgow coma scale.
Global Rationale: ADH is essential to fluid balance. Lack of ADH causes a condition called diabetes insipidus. Untreated ADH results in death from shock. The conduction system is not directly affected, although heart rate speeds up in response to volume loss, and the blood pressure drops if the loss is extreme. ADH does not impact the peripheral nervous system or reflexes and does not directly affect the client's Glasgow coma scale.

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Gracias!

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TYSM