A client who is newly diagnosed with diabetes insipidus (DI) is receiving a synthetic vasopressin intravenously. Which side effect of vasopressin reported by the client should the nurse report to the healthcare provider?

Worsening headache.

Low urine specific gravity.

Polyuria.

Polydipsia.

Answer and Explanation

The Correct Answer is A

A. Worsening headache:
Vasopressin is used to manage diabetes insipidus by reducing excessive urine output and increasing water reabsorption. A worsening headache could indicate an adverse reaction or side effect such as water intoxication or an increase in intracranial pressure, which requires immediate attention from the healthcare provider.

B. Low urine specific gravity:
Vasopressin should increase urine specific gravity by concentrating the urine. A low urine specific gravity would indicate that the medication is not effectively concentrating the urine, but it is not an immediate or severe side effect needing urgent reporting.

C. Polyuria:
Polyuria (excessive urine output) is a characteristic of diabetes insipidus, and vasopressin is intended to reduce this symptom. If polyuria persists despite treatment, it suggests that the medication is not working as intended but does not indicate a severe side effect.

D. Polydipsia:
Polydipsia (excessive thirst) can occur in diabetes insipidus and may continue despite treatment with vasopressin. While it indicates ongoing symptoms, it is not a severe side effect of the medication that would require urgent reporting to the healthcare provider.

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Correct Answer is C

Explanation

A) Adding the herb can decrease the need for corticosteroids: There is no substantial evidence that St. John’s Wort affects the need for corticosteroids. Its primary interactions are with medications metabolized by the liver, particularly cyclosporine, rather than affecting corticosteroid requirements directly.

B) Ingestion of St. John's Wort can reduce the client's intake of sodium: St. John’s Wort does not impact sodium intake. Its known interactions are with drugs, particularly those metabolized by the liver, rather than affecting dietary intake or sodium levels.

C) St. John's Wort can decrease plasma concentrations of cyclosporine: St. John’s Wort is a potent inducer of cytochrome P450 enzymes, which can lead to decreased plasma levels of cyclosporine, an immunosuppressant crucial for preventing graft rejection. This interaction can result in subtherapeutic levels of cyclosporine and increase the risk of graft rejection.

D) The client probably used this herb to treat depression: While it is true that St. John’s Wort is commonly used for its antidepressant effects, this is not the most significant concern in the context of a renal transplant. The primary issue is its interaction with cyclosporine, which can significantly impact transplant outcomes.

A. Avoid prolonged exposure to direct sunlight. B. Stop the oral contraceptive immediately. C. Take the medications at least 12 hours apart. D. Use an additional form of contraception.

Correct Answer is D

Explanation

A) Avoid prolonged exposure to direct sunlight: While erythromycin can increase sensitivity to sunlight, this is not directly related to the interaction between oral contraceptives and erythromycin. The primary concern with erythromycin and oral contraceptives is their interaction rather than sun exposure.

B) Stop the oral contraceptive immediately: There is no need to stop oral contraceptives when taking erythromycin. However, erythromycin can potentially reduce the effectiveness of oral contraceptives, so additional precautions should be taken rather than discontinuing the contraceptive.

C) Take the medications at least 12 hours apart: Timing of administration is not a primary concern for this interaction. The main issue is the potential reduction in contraceptive efficacy rather than timing the doses of the medications.

D) Use an additional form of contraception: Erythromycin can potentially decrease the effectiveness of oral contraceptives due to its effect on liver enzymes and drug metabolism. It is advisable to use an additional form of contraception to prevent unintended pregnancy while taking erythromycin.

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A client who is newly diagnosed with diabetes insipidus (DI) is receiving a synthetic vasopressin intravenously. Which side effect of vasopressin reported by the client should the nurse report to the healthcare provider?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Correct Answer is D

Explanation

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