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.
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.
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