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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"C"}}
Explanation
Indication of potential improvement:
• Shortness of breath with exertion
• Lung sounds clear
Indication of potential worsening condition:
• WBC count 11,800/mm³
• Temperature 38.5°C (101.3°F)
• Weight 113 kg (249 lb)
• Creatinine 1.8 mg/dL
Rationale:
• Shortness of breath with exertion: Previously, the client had dyspnea at rest. Improvement to exertional dyspnea suggests better fluid balance and cardiac function.
• Lung sounds clear: The initial presence of crackles indicated pulmonary congestion. Clear lung sounds suggest reduced fluid overload, reflecting improved cardiac function.
• WBC count 11,800/mm³: An increasing WBC count suggests a possible infection, which can worsen heart failure by increasing metabolic demands and fluid retention.
• Temperature 38.5°C (101.3°F): Fever indicates a possible infection, such as a UTI, which the client has a history of. Infections can exacerbate heart failure by triggering systemic inflammation and fluid shifts.
• Weight 113 kg (249 lb): Weight gain in heart failure is often due to fluid retention, indicating worsening congestion.
• Creatinine 1.8 mg/dL: A rising creatinine level suggests worsening kidney function, which may result from reduced perfusion due to heart failure or excessive diuresis from furosemide.
Correct Answer is B
Explanation
A. Graham crackers: Hard, crunchy foods can trigger pain by irritating the trigeminal nerve, making them unsuitable for clients with trigeminal neuralgia. Soft, easy-to-swallow foods are preferred.
B. Vanilla pudding: Soft, smooth-textured foods are recommended to minimize irritation of the trigeminal nerve. Vanilla pudding requires minimal chewing, reducing the risk of triggering pain.
C. Ice cream: Extremely cold foods can act as a trigeminal nerve irritant and may provoke pain episodes. Lukewarm or room-temperature foods are preferable.
D. Vegetable soup: Although liquid-based, vegetable soup often contains solid pieces that require chewing, which can increase the risk of triggering pain. Blended or pureed soups are a better option.
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