The nurse observed that a client with diabetic ketoacidosis is experiencing abnormally deep, regular, and rapid respirations. How would the nurse document this observation in the medical record?

Choice A reason: This is incorrect because the adrenal gland is not involved in the thirst mechanism. The adrenal gland is responsible for producing hormones such as cortisol, aldosterone, and adrenaline, which regulate stress response, blood pressure, and metabolism.

Choice B reason: This is incorrect because the cerebral cortex is not involved in the thirst mechanism. The cerebral cortex is the outer layer of the brain that is responsible for higher cognitive functions such as memory, language, and reasoning.

Choice C reason: This is incorrect because the pituitary gland is not directly involved in the thirst mechanism. The pituitary gland is a small gland at the base of the brain that produces hormones that control growth, reproduction, and metabolism. However, the pituitary gland does secrete antidiuretic hormone (ADH), which is regulated by the hypothalamus and affects water balance in the body.

Choice D reason: This is correct because the hypothalamus is the location of the thirst mechanism. The hypothalamus is a part of the brain that regulates many bodily functions such as temperature, appetite, sleep, and emotions. The hypothalamus also monitors the blood osmolarity and triggers the sensation of thirst when the blood is too concentrated.

Choice A reason: 60 mL of urine in a 2-hour period is not very concerning for a nurse, as it is within the normal range of urine output. The average urine output for an adult is about 1 to 2 L per day, or 40 to 80 mL per hour¹.

Choice B reason: 720 mL of urine in a 24-hour period is slightly below the normal range, but not alarming. It may indicate mild dehydration or reduced fluid intake, but it is not a sign of fluid volume excess or kidney failure¹.

Choice C reason: 600 mL of urine in a 10-hour period is also within the normal range of urine output, and does not indicate any problem with fluid balance or renal function¹.

Choice D reason: 100 mL of urine in a 5-hour period is the most concerning for a nurse, as it indicates oliguria, or abnormally low urine output. Oliguria is defined as urine output less than 400 mL per day, or less than 20 mL per hour². It may be caused by acute or chronic kidney injury, urinary obstruction, shock, dehydration, or fluid volume excess². Oliguria can lead to fluid overload, electrolyte imbalance, acidosis, and uremia, and requires immediate medical attention².