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 A

Explanation

A. In SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion), the body retains excessive water, leading to dilutional hyponatremia (low sodium levels). Administering hypertonic saline (3% NS) can exacerbate the condition by rapidly increasing sodium levels, which may cause demyelination of neurons (a condition called osmotic demyelination syndrome). Hypertonic saline is typically only used in severe hyponatremia with neurologic symptoms and should be carefully monitored.
B. Seizure precautions are appropriate in SIADH due to the risk of seizures from severe hyponatremia, which can lead to cerebral edema and neurological compromise.
C. Fluid restriction of 1000 mL/day is appropriate in SIADH to manage the dilutional hyponatremia by preventing further fluid retention.
D. A sodium-restricted diet is also recommended in SIADH to avoid further dilution of sodium levels and prevent worsening of hyponatremia.

A. Encourage the client to ambulate frequently. B. Encourage coughing and deep breathing. C. Encourage regular use of the incentive spirometer. D. Encourage the client to increase fluid intake.

Correct Answer is D

Explanation

A. Ambulating frequently helps with overall circulation and lung expansion but does not directly affect the thinning of respiratory secretions.
B. Coughing and deep breathing help clear secretions but are not effective for thinning them.
C. The incentive spirometer is used to improve lung expansion and prevent atelectasis, but it does not directly thin secretions.
D. Increasing fluid intake helps thin respiratory secretions by providing hydration, which makes mucus easier to clear from the respiratory tract.

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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

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