A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should indicate to the nurse a therapeutic response to the medication?

Increase in serum glucose

Decrease in blood pressure

Decrease in urine output

Increase in WBC count

Answer and Explanation

The Correct Answer is C

Choice A Reason:
Increase in serum glucose is incorrect. Desmopressin, which is a synthetic form of vasopressin, primarily affects water reabsorption in the kidneys and doesn't directly impact glucose levels. Therefore, an increase in serum glucose wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.
Choice B Reason:
Decrease in blood pressure is incorrect. Desmopressin is primarily used for its antidiuretic effect, concentrating urine by increasing water reabsorption in the kidneys. It typically doesn't have a significant impact on blood pressure. Therefore, a decrease in blood pressure wouldn't typically be an anticipated therapeutic response to desmopressin in this context.
Choice C Reason:
Decrease in urine output is correct. Desmopressin is a synthetic form of vasopressin (antidiuretic hormone) used to treat diabetes insipidus, a condition characterized by excessive urination and extreme thirst due to the inability to concentrate urine. The primary goal of desmopressin is to reduce urine output by increasing water reabsorption in the kidneys, thereby decreasing excessive urination. Therefore, a decrease in urine output would indicate a therapeutic response to the medication in this context.
Choice D Reason:
Increase in WBC count is incorrect. Desmopressin's action is centered on affecting kidney function by regulating water reabsorption and does not involve changes in white blood cell count. Consequently, an increase in WBC count wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.

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Correct Answer is D

Explanation

Choice A Reason:
Discard the medication if it is yellow is incorrect. While amphotericin B lipid complex can have a yellowish color, it's important to follow specific guidelines provided by the manufacturer or pharmacy regarding any discoloration or changes in the medication's appearance. Discoloration could indicate degradation or contamination, and it's crucial to adhere to specific institutional policies in such cases.
Choice B Reason:
Administer the medication over 2 hr is incorrect. Amphotericin B lipid complex is usually given over a longer duration (e.g., several hours) due to the potential for infusion-related reactions. Intermittent IV bolus administration over 2 hours might not be appropriate and can increase the risk of adverse reactions.
Choice C Reason:
Use a gravity flow set is incorrect. For medications like amphotericin B lipid complex, which often require precise infusion rates and careful monitoring, using an IV infusion pump is usually recommended instead of a gravity flow set. An infusion pump allows for more accurate control of the infusion rate and reduces the risk of errors.
Choice D Reason:
Prime the tubing with 0.9% sodium chloride is correct. Amphotericin B lipid complex should be administered according to specific instructions and precautions. Priming the IV tubing with 0.9% sodium chloride helps ensure that the medication is effectively delivered to the patient and that the medication is not affected by remnants of previous IV solutions in the tubing.

A. Sodium 141 mEq/L B. Potassium 2.5 mEq/L C. WBC count 8,000/mm3 D. INR 1.0

Correct Answer is B

Explanation

Choice A Reason:
Sodium 141 mEq/L is incorrect. This value is within the normal range (usually around 135-145 mEq/L).
Choice B Reason:
Potassium 2.5 mEq/ is correct. Furosemide, a loop diuretic, can lead to potassium loss through increased urine output. If a client already has a low potassium level (hypokalemia), administering furosemide can further decrease potassium levels, potentially causing or worsening hypokalemia. Hypokalemia can lead to various complications, including cardiac arrhythmias.
Choice C Reason:
WBC count 8,000/mm3 is incorrect. This value falls within the normal range for white blood cell count.
Choice D Reason:
INR 1.0: An INR of 1.0 is within the normal range for a person not on anticoagulation therapy.

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A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should indicate to the nurse a therapeutic response to the medication?

Nursing Test Bank

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Explanation

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