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 the nurse identify as an indication of a therapeutic response to the medication?

Increase in serum sodium

Decrease in urine output

Increase in heart rate

Decrease in blood pressure

Answer and Explanation

The Correct Answer is B

A.   Increase in serum sodium: Desmopressin, a synthetic form of vasopressin, works to decrease urine output and increase water reabsorption in the kidneys. Therefore, a therapeutic response to desmopressin would not result in an increase in serum sodium; rather, it would aim to normalize serum sodium levels by reducing excessive urine output.
B.   Decrease in urine output: The primary therapeutic goal of desmopressin in the treatment of diabetes insipidus is to decrease urine output by increasing water reabsorption in the kidneys. Therefore, a decrease in urine output would indicate a positive response to the medication.
C.   Increase in heart rate: Desmopressin primarily affects kidney function by increasing water reabsorption and does not typically have a direct effect on heart rate. Therefore, an increase in heart rate would not be a manifestation of a therapeutic response to desmopressin.
D.   Decrease in blood pressure: Desmopressin works to increase water reabsorption in the kidneys and does not typically cause significant changes in blood pressure. Therefore, a decrease in blood pressure would not be a manifestation of a therapeutic response to desmopressin.

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Correct Answer is D

Explanation

A. Verapamil: Verapamil is a calcium channel blocker primarily used to treat supraventricular

tachycardias, not ventricular dysrhythmias. It is not typically used for life-threatening ventricular dysrhythmias.
B. Digoxin: Digoxin is a cardiac glycoside used primarily for atrial fibrillation and heart failure, not ventricular dysrhythmias. It is not typically used for life-threatening ventricular
dysrhythmias.

C. Dopamine: Dopamine is a sympathomimetic medication used for hemodynamic support in hypotension and shock. While it may be used in some cases of unstable bradycardia, it is not the first-line medication for life-threatening ventricular dysrhythmias.
D. Amiodarone: Amiodarone is an antiarrhythmic medication used for the treatment of various ventricular and supraventricular dysrhythmias, including life-threatening ventricular
dysrhythmias such as ventricular tachycardia and ventricular fibrillation. It is often used as a first-line medication for these conditions due to its efficacy and safety profile. Therefore, the nurse should anticipate administering amiodarone for the client's life-threatening ventricular dysrhythmia.

A. Dobutamine B. Epinephrine C. Dexamethasone D. Nitroprusside

Correct Answer is D

Explanation

A. Dobutamine: Dobutamine is a sympathomimetic medication used to increase cardiac output in conditions such as heart failure or cardiogenic shock. It is not indicated for the management of severe hypertension.

B. Epinephrine: Epinephrine is a sympathomimetic medication used for the management of severe allergic reactions (anaphylaxis), cardiac arrest, and severe asthma exacerbations. It is not indicated for the management of severe hypertension.
C. Dexamethasone: Dexamethasone is a corticosteroid medication used for a variety of

conditions, including inflammation, allergic reactions, and certain cancers. It is not indicated for the management of severe hypertension.
D. Nitroprusside: Nitroprusside is a potent vasodilator used for the rapid reduction of blood pressure in hypertensive emergencies, such as hypertensive crises or malignant hypertension. It acts quickly to dilate both arterial and venous vessels, leading to a rapid decrease in blood pressure. Therefore, it is the appropriate choice for this client with severe hypertension and a severe headache.

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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 the nurse identify as an indication of a therapeutic response to the medication?

Nursing Test Bank

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