A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?
Desmopressin acetate
Spironolactone
Furosemide
Dopamine
The Correct Answer is A
A. Desmopressin acetate: This synthetic form of antidiuretic hormone (ADH) reduces excessive urine output by increasing water reabsorption in the kidneys. It helps restore fluid balance and prevent dehydration in diabetes insipidus. Without treatment, continued polyuria can lead to severe dehydration and electrolyte imbalances.
B. Spironolactone: This potassium-sparing diuretic promotes sodium and water excretion by blocking aldosterone receptors. It is used to treat conditions like heart failure and hyperaldosteronism but would worsen polyuria and dehydration in diabetes insipidus.
C. Furosemide: This loop diuretic inhibits sodium and chloride reabsorption in the kidneys, leading to increased urine output. Administering it to a client with diabetes insipidus would further aggravate excessive fluid loss and the risk of dehydration.
D. Dopamine: This vasopressor is used to improve cardiac output and blood pressure in conditions like shock. It does not affect ADH levels or urine concentration and would not help manage the excessive diuresis seen in diabetes insipidus.
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Related Questions
Correct Answer is C
Explanation
A. Fluid overload: While NG tubes can be used for enteral feeding, they are often associated with fluid losses from suctioning or drainage rather than overload. Clients with NG tubes are more prone to dehydration and electrolyte imbalances.
B. Metabolic acidosis: NG tube suctioning primarily removes gastric contents, which are rich in hydrochloric acid. This can lead to metabolic alkalosis rather than acidosis due to excessive loss of acidic gastric secretions.
C. Hyponatremia: Prolonged NG tube suctioning or drainage can lead to the loss of sodium-rich gastric secretions, resulting in hyponatremia. Monitoring electrolyte levels and replacing lost fluids appropriately is essential to prevent imbalances.
D. Constipation: NG tubes are more commonly associated with diarrhea due to enteral feeding formulas rather than constipation. However, reduced oral intake and immobility could contribute to constipation in some cases.
Correct Answer is ["A","D","E","G"]
Explanation
- Pain level: The client's reported pain level decreased from 7 to 5 after receiving nitroglycerin and oxygen therapy. A reduction in pain indicates that the treatment is effective and the client's condition is improving.
- Heart rate: The heart rate decreased from 120/min to 100/min between assessments, suggesting improved cardiac function and stability. A lower heart rate can indicate a better response to treatment and improved hemodynamic status.
- Blood pressure: The blood pressure improved from 176/82 mm Hg to 110/62 mm Hg, indicating a more stable hemodynamic status. However, it is important to ensure that the blood pressure does not drop too low; overall, the trend suggests an improvement in circulation.
- Oxygenation saturation: The oxygen saturation improved from 89% on room air to 93% after oxygen therapy was initiated. An increase in oxygen saturation indicates improved respiratory function and effective oxygenation, which is critical for recovery in clients with cardiac issues.
- Urinary output: There is no documented information regarding the client's urinary output in the provided data, making it difficult to assess improvement in this area. Monitoring urinary output is essential for evaluating kidney function and fluid balance, but it cannot be determined from the available information.
- Echocardiogram results: The echocardiogram results indicated a myocardial infarction, which does not show improvement but rather confirms the severity of the client's condition. While treatment may address the effects of the infarction, the diagnosis itself indicates ongoing concern.
- Respiratory rate: The respiratory rate remained at 22/min, which is still elevated. While it is unchanged, an improvement would typically be reflected by a decrease in the respiratory rate, indicating better respiratory status. The persistent elevated rate suggests that further monitoring and interventions may still be needed.
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