A nurse administers desmopressin to a client who has a diagnosis of diabetes insipidus. The nurse recognizes that which of the following laboratory findings indicate a therapeutic effect of the medication?

Blood glucose 80 mg/dL

Serum sodium 146 mEq/L

Blood urea nitrogen (BUN) 15 mg/dL

Urine specific gravity 1.015

Answer and Explanation

The Correct Answer is D

A. Blood glucose levels are not directly affected by desmopressin, as it is used to treat diabetes insipidus, which is related to antidiuretic hormone (ADH) deficiency, not glucose metabolism.
B. A serum sodium level of 146 mEq/L is slightly elevated and may indicate dehydration, which is common in diabetes insipidus if not well controlled. Desmopressin should help lower the sodium level by reducing the excessive urine output.
C. Blood urea nitrogen (BUN) is typically used to assess kidney function and hydration status, but it is not a primary indicator of the effectiveness of desmopressin in treating diabetes insipidus.
D. A urine specific gravity of 1.015 is within the normal range and indicates more concentrated urine, which is a therapeutic effect of desmopressin. The medication helps the kidneys retain water, leading to more concentrated urine, and improving symptoms of diabetes insipidus.

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Correct Answer is C

Explanation

A. "You need the stool softener because it will be hard to defecate while you remain in bed.": This is not the most appropriate response. While immobility can make bowel movements more difficult, the primary concern following pituitary surgery is the avoidance of straining due to the potential for increased intracranial pressure (ICP). The emphasis should be on avoiding pressure on the surgical site rather than general difficulties from immobility.
B. "Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery.": This is misleading. While pituitary surgery may influence certain bodily functions, the most critical concern is preventing straining to avoid raising ICP. The focus should be on explaining the rationale for avoiding pressure on the surgical site.
C. "It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site.": This is the correct response. Straining during bowel movements can increase ICP, which could potentially compromise healing or lead to complications after pituitary surgery. This explanation directly addresses the patient's safety and emphasizes the need for stool softeners to prevent straining.
D. "You can choose not to take the stool softener if you feel you do not need it.": This response is inappropriate because it does not emphasize the importance of preventing straining, which is a critical consideration after pituitary surgery. The nurse should provide education on the necessity of the stool softener to avoid complications rather than leaving the decision solely to the patient.

A. Serum sodium, 150 mmol/L; serum potassium, 2.5 mmol/L B. Serum sodium, 140 mmol/L; serum potassium, 5.0 mmol/L C. Serum sodium, 130 mmol/L; serum potassium, 7.5 mmol/L D. Serum sodium, 130 mmol/L; serum potassium, 2.5 mmol/L

Correct Answer is A

Explanation

A. Hyperaldosteronism causes sodium retention and potassium excretion, leading to elevated serum sodium levels and low potassium levels. A serum potassium level of 2.5 mmol/L is indicative of hypokalemia, which is a classic finding in hyperaldosteronism.
B. This serum electrolyte pattern (normal sodium and potassium) is not suggestive of hyperaldosteronism.
C. In hyperaldosteronism, the serum sodium is typically elevated, but the potassium level is very low, not elevated as seen in this option.
D. While low potassium is indicative of hyperaldosteronism, the sodium level is abnormally low in this case, which is not typical for this condition. Hyperaldosteronism typically presents with elevated sodium.

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A nurse administers desmopressin to a client who has a diagnosis of diabetes insipidus. The nurse recognizes that which of the following laboratory findings indicate a therapeutic effect of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which response is best when a patient refuses a stool softener after pituitary surgery?

Correct Answer is C

Explanation

Which serum electrolyte value alerts the nurse to the possibility of hyperaldosteronism?

Correct Answer is A

Explanation

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