A nurse suspects a client has diabetes insipidus. What are the priority interventions? Select all that apply.

Monitor for hypernatremia.

Monitor neuro status.

Monitor for hyponatremia.

Monitor urine specific gravity.

Monitor strict I&O.

Answer and Explanation

Correct Answer : A

Choice A: Monitor for hypernatremia.

Hypernatremia, or high sodium levels in the blood, is a common complication of diabetes insipidus due to excessive water loss and insufficient water intake. Monitoring for hypernatremia involves regular blood tests to check sodium levels. Symptoms of hypernatremia include extreme thirst, confusion, muscle twitching, and seizures. Early detection and management are crucial to prevent severe complications.

Choice B: Monitor neuro status.

Monitoring neurological status is essential in patients with diabetes insipidus because severe hypernatremia can lead to neurological symptoms such as confusion, irritability, seizures, and even coma. Regular assessments of mental status, level of consciousness, and neurological function help in early detection of complications and timely intervention.

Choice C: Monitor for hyponatremia.

While hyponatremia (low sodium levels) is less common in diabetes insipidus, it can occur if there is excessive water intake without adequate sodium replacement. Symptoms include headache, nausea, vomiting, confusion, and seizures. Monitoring sodium levels helps in maintaining a balance and preventing complications.

Choice D: Monitor urine specific gravity.

Urine specific gravity measures the concentration of solutes in the urine. In diabetes insipidus, urine is typically very dilute, with a specific gravity of less than 1.005. Regular monitoring helps in assessing the effectiveness of treatment and the patient’s hydration status. It also aids in differentiating diabetes insipidus from other conditions with similar symptoms.

Choice E: Monitor strict I&O.

Strict monitoring of intake and output (I&O) is crucial in managing diabetes insipidus. This involves accurately measuring all fluids consumed and excreted to ensure proper hydration and electrolyte balance. It helps in identifying trends in fluid loss and guiding appropriate fluid replacement therapy.

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Correct Answer is A

Explanation

Choice A: Metformin

Reason: Metformin is known to interact with contrast material, particularly iodinated contrast media, and can increase the risk of acute kidney injury (AKI). This interaction can lead to a condition known as contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI). Metformin is primarily excreted by the kidneys, and impaired renal function can lead to its accumulation, increasing the risk of lactic acidosis, a rare but serious complication. Therefore, it is generally recommended to withhold metformin before and after the administration of contrast media until renal function is confirmed to be normal.

Choice B: Carvedilol

Reason: Carvedilol is a beta-blocker used to treat high blood pressure and heart failure. It does not have a known interaction with contrast media that would increase the risk of acute kidney injury. Carvedilol primarily affects the cardiovascular system and does not significantly impact renal function or interact with contrast agents.

Choice C: Nitroglycerin

Reason: Nitroglycerin is used to treat angina and other heart conditions by dilating blood vessels. It does not interact with contrast media in a way that would increase the risk of acute kidney injury. Nitroglycerin’s primary effects are on the cardiovascular system, and it does not have nephrotoxic properties.

Choice D: Atorvastatin

Reason: Atorvastatin is a statin used to lower cholesterol levels. While it can have effects on liver enzymes and muscle tissue, it does not interact with contrast media to increase the risk of acute kidney injury. Atorvastatin is metabolized by the liver and does not significantly impact renal function.

Correct Answer is ["31"]

Explanation

Step 1: Calculate the total infusion time in minutes.

8 hours × 60 minutes/hour = 480 minutes

Result at each step = 480 minutes

Step 2: Calculate the total number of drops to be infused.

1,000 mL × 15 drops/mL = 15,000 drops

Result at each step = 15,000 drops

Step 3: Calculate the infusion rate in drops per minute.

15,000 drops ÷ 480 minutes = 31.25 drops/minute

Result at each step = 31.25 drops/minute

Step 4: Round to the nearest whole number if necessary.

31.25 drops/minute rounds to 31 drops/minute

Result at each step = 31 drops/minute

Therefore, the nurse should run the IV infusion at a rate of 31 drops per minute.

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A nurse suspects a client has diabetes insipidus. What are the priority interventions? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

Correct Answer is A

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Exhibits You retrieved regular insulin 100 units in 1 ml. How many ml should you administer? Note Enter ONLY the number DO NOT enter the unit(s) of measurement

Correct Answer is ["31"]

Explanation

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