A nurse is planning care for a client who has a new diagnosis of diabetes insipidus. Which of the following interventions should the nurse include in the plan of care?

Measure blood glucose levels every 4 hr.

Check urine specific gravity.

Administer a diuretic

Initiate fluid restrictions

Answer and Explanation

The Correct Answer is B

A.   This intervention is not relevant to diabetes insipidus, which affects water balance rather than glucose levels.
B.   Checking urine specific gravity helps assess the concentration of urine, which can be very dilute in diabetes insipidus.
C.   Diabetes insipidus is already characterized by excessive urination (polyuria), so administering a diuretic would exacerbate fluid loss.
D.   Fluid restrictions are not typically necessary in diabetes insipidus because the primary issue is water loss rather than retention.

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Correct Answer is B

Explanation

A. Polyuria (excessive urination) is not typically associated with low calcium levels. It may occur in conditions such as diabetes mellitus or diabetes insipidus.
B. Hypocalcemia (low calcium levels) can lead to neuromuscular irritability, which may manifest as muscle tremors or spasms. This is a classic sign of hypocalcemia.
C. Dry, sticky mucous membranes are more indicative of dehydration rather than hypocalcemia.
D. Negative Chvostek's sign means the absence of facial muscle twitching upon tapping the facial nerve, which is not expected in hypocalcemia.

A. Place the child on a low-sodium diet. B. Monitor the child for fluid volume excess. C. Discuss the manifestations of hyperglycemia with the parents. D. Teach the parents about cortical replacement therapy.

Correct Answer is D

Explanation

A. Placing the child on a low-sodium diet is not a priority action for managing Addison's disease. Sodium restriction may be necessary in some cases, but it's not the primary intervention.
B. Monitoring the child for fluid volume excess is not directly related to managing Addison's disease. Addison's disease often leads to hypovolemia due to decreased aldosterone secretion.
C. Discussing manifestations of hyperglycemia may not be directly relevant to Addison's disease, which primarily affects cortisol and aldosterone levels, not glucose metabolism.
D. Teaching the parents about cortical replacement therapy is crucial. Addison's disease results from adrenal insufficiency, and cortical replacement therapy, typically with glucocorticoids and mineralocorticoids, is the mainstay of treatment.

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