A neonate is born with bilateral mild talipes equinovarus (club foot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation?

Choice A reason:

Performing an ultrasound to determine if there is urinary retention is not the immediate priority action. While an ultrasound can help assess urinary retention, the presence of edema, redness, and the foreskin being behind the glans penis suggests a condition known as paraphimosis. Paraphimosis is a medical emergency that requires prompt attention to prevent complications such as tissue damage. Therefore, alerting the ER physician is the priority action.

Choice B reason:

Asking the parents specifically how long the infant has not voided is important for gathering information, but it is not the immediate priority action. The clinical signs of edema, redness, and the foreskin being behind the glans penis indicate a potential emergency that requires immediate medical intervention. While obtaining a detailed history is important, the nurse should first alert the ER physician to ensure timely management.

Choice C reason:

Alerting the ER physician to the patient’s condition is the correct priority action. The presence of edema, redness, and the foreskin being behind the glans penis suggests paraphimosis, which is a urological emergency. Prompt intervention is necessary to reduce the foreskin and restore normal blood flow to prevent tissue damage3. The ER physician can provide the necessary treatment and management for this condition.

Choice D reason:

Continuing to monitor the patient in the ER setting is not appropriate without first addressing the potential emergency. The signs of edema, redness, and the foreskin being behind the glans penis indicate a condition that requires immediate medical attention. Monitoring alone is insufficient; the nurse must alert the ER physician to ensure prompt intervention.

Choice A reason:

Diabetes insipidus: Desmopressin acetate (DDAVP) is primarily used to treat central diabetes insipidus, a condition where the body lacks sufficient antidiuretic hormone (ADH) due to issues with the pituitary gland or hypothalamus. This hormone helps regulate water balance in the body, and desmopressin acts as a synthetic replacement to reduce frequent urination and excessive thirst.

Choice B Reason:

Acute adrenocortical insufficiency: This condition, also known as Addison’s disease, involves insufficient production of cortisol and aldosterone by the adrenal glands. Desmopressin is not used to treat this condition as it does not address the hormonal deficiencies involved.

Choice C Reason:

Hypopituitarism: This condition involves the underproduction of one or more hormones by the pituitary gland. While desmopressin can be used to manage specific symptoms related to ADH deficiency, it is not a comprehensive treatment for hypopituitarism, which requires hormone replacement therapy for multiple hormones.

Choice D Reason:

Syndrome of inappropriate antidiuretic hormone (SIADH): SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Desmopressin is not used to treat SIADH; in fact, it would exacerbate the condition by increasing ADH levels.