A nurse is assessing a 5-year-old child who has diabetes insipidus and is receiving desmopressin.
Which of the following findings should the nurse identify as an indication that the medication is effective?
Heart rate 140/min.
Cessation of nocturnal enuresis.
Capillary refill 3 seconds.
Absence of hypoglycemic episodes.
The Correct Answer is B
Choice A rationale:
A heart rate of 140/min is not a specific indicator of desmopressin effectiveness in a child with diabetes insipidus. The effectiveness of desmopressin is primarily evaluated based on the reduction in excessive urination and thirst associated with the condition. Monitoring heart rate is essential in certain situations but is not a direct measure of desmopressin efficacy in managing diabetes insipidus.
Choice B rationale:
Cessation of nocturnal enuresis (bedwetting) is a significant indication that desmopressin, an antidiuretic hormone, is effective. One of the main symptoms of diabetes insipidus is excessive urination, including during the night, leading to bedwetting. When desmopressin effectively reduces urine production, patients often experience improvement in these symptoms, including the cessation of nocturnal enuresis.
Choice C rationale:
Capillary refill of 3 seconds is a measurement used to assess peripheral perfusion and circulatory status. While it is essential to monitor capillary refill in pediatric patients, especially in cases of dehydration or circulatory compromise, it is not a specific indicator of desmopressin effectiveness in managing diabetes insipidus. Capillary refill time is more relevant in the assessment of cardiovascular function and fluid status.
Choice D rationale:
The absence of hypoglycemic episodes is not a direct indicator of desmopressin effectiveness. Diabetes insipidus is unrelated to blood glucose levels, as it involves the dysregulation of water balance due to insufficient antidiuretic hormone. While it is essential to monitor blood glucose levels in patients with diabetes mellitus, it is not relevant to assessing the effectiveness of desmopressin in treating diabetes insipidus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
The correct answers are Choices A and C.
Choice A rationale: Severe hypertension in pregnancy disrupts placental perfusion and vascular integrity, increasing risk of placental abruption due to premature separation and hemorrhage, threatening both maternal and fetal outcomes.
Choice B rationale: Cervical insufficiency is linked to structural weakness or trauma, not hypertension; it typically presents with painless dilation and is unrelated to elevated blood pressure or vascular compromise.
Choice C rationale: Hypertensive encephalopathy and preeclampsia can progress to eclampsia, marked by seizures. Elevated BP increases cerebral edema and excitability, triggering convulsions if unmanaged.
Choice D rationale: Hypoglycemia is not a direct consequence of hypertension; it’s more associated with insulin dysregulation, poor intake, or medication effects, not elevated blood pressure.
Choice E rationale: Heart failure may occur in chronic hypertension but is less acute than seizure or abruption risk in this context. No signs of fluid overload or cardiac decompensation are present in the vitals.
Correct Answer is B
Explanation
Choice A rationale:
Having the client exhale deeper than she inhales is a breathing technique that can help manage pain but does not specifically address the request for pain management techniques during natural childbirth. Option A does not provide comprehensive information about pain management strategies during labor.
Choice B rationale:
Providing information about the use of hydrotherapy during labor is a valid suggestion. Hydrotherapy, such as taking a warm bath or using a shower during labor, can help alleviate pain and promote relaxation. It is a non-pharmacological pain management option that the client can consider.
Choice C rationale:
Encouraging the client to have the family exit the room when the pain is unbearable may offer emotional support, but it does not provide a direct pain management technique. Additionally, the presence of loved ones can be a source of comfort for the client during labor.
Choice D rationale:
Informing the client that using pharmacological pain management will not impact the delivery is a true statement. Pharmacological pain relief methods, such as epidural anesthesia, do not affect the progress of labor or the outcome of delivery. However, this option does not provide an alternative pain management technique for the client who desires natural childbirth.
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