SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone) and diabetes insipidus are two disorders that are affected by the anti-diuretic hormone (ADH) but in opposite ways. SIADH and DI are topics covered on the NCLEX exam and in nursing school.
This quiz on SIADH and DI will test your ability to differentiate between the two disorders. These disorders can be confusing to students, but this quiz was designed to help you learn the difference between them.
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Lecture on SIADH vs DI
Quiz on SIADH vs DI
1. A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly “water” weight. In addition, they report the patient hasn’t been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient’s HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with?
B. Diabetes Insipidus
C. Addison’s Disease
D. Fluid Volume Deficient
The answer is A: SIADH
2. In the scenario above what drug do you anticipate the patient will be started on per doctor’s order?
A. Desmopressin (DDAVP) IV
The answer is B: Declomycin
3. Which of the following signs and symptoms is NOT expected with Diabetes Insipidus?
D. Extreme thirst
The answer is C: Polyphagia
4. You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient?
A. Fluid volume overload
B. Fluid volume deficient
C. Acute pain
D. Impaired skin integrity
The answer is A: Fluid volume overload
5. A patient with a mild case of diabetes insipidus is started on Diabinese. What would you include in your patient teaching with this patient?
A. Signs and symptoms of hypoglycemia
B. Restricting foods containing caffeine
C. Taking the medication on an empty stomach
D. Drinking 16 oz of water when taking the medication
The answer is A: Signs and symptoms of hypoglycemia
6. Which patient is most at risk for developing Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)?
A. A patient diagnosed with small cell lung cancer.
B. A patient whose kidney tubules are failing to reabsorb water.
C. A patient with a tumor on the anterior pituitary gland.
D. A patient taking Declomycin.
The answer is A: A patient diagnosed with small cell lung cancer.
7. A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention?
A. Sodium level of 136.
B. Patient reports urinating more frequently.
C. Potassium level of 5.0.
D. Assessment finding of crackles throughout the lung fields.
The answer is D: Assessment finding of crackles throughout the lung fields. Remember that when administering a hypertonic solution you have to do this very slowly and watch for volume overload. Hypertonic solutions pull fluid from the cell (which is already water intoxicated) and place it back into the vascular system…therefore, crackles in the lungs are a sign there is too much fluid in the body and the heart can not compensate so the fluid is backing up into the lungs. This would require intervention.
8. The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH.
A. high, low
B. absent, absent
C. low, high
D. low, low
The answer is C: low, high
9. Where is the anti-diuretic hormone PRODUCED in the body?
A. Anterior pituitary gland
B. Posterior pituitary gland
The answer is C: Hypothalamus
10. Where is the anti-diuretic hormone SECRETED in the body?
C. Posterior Pituitary gland
D. Anterior pituitary gland
The answer is C: Posterior Pituitary gland
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