Which of the information below obtained when caring for a patient who has been admited for evaluation of diabetes insipidus will be of greatest concern to the nurse?

The patient has a urine output of 800 ml/hr.

The patient is confused and lethargic.

The patient's urine specific gravity is 1.003.

The patient had a recent head injury.

Answer and Explanation

The Correct Answer is B

Diabetes insipidus is a condition where the body is not able to regulate water balance properly, leading to excessive urine output and dehydration. The patient's urine output of 800 ml/hr (option A) and low urine specific gravity of 1.003 (option C) is consistent with diabetes insipidus and requires monitoring, but they are not as immediately concerning as the patient's confusion and lethargy.

Confusion and lethargy may indicate severe dehydration, electrolyte imbalances, or even brain swelling (if the patient had a recent head injury, as mentioned in option D). These symptoms require immediate attention to prevent further complications and ensure the patient's safety.

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Correct Answer is A

Explanation

GERD can increase the risk of aspiration (inhalation of stomach contents into the lungs), which can cause respiratory issues, including abnormal breath sounds. In these cases, monitoring of breath sounds may be more appropriate than monitoring of bowel sounds.

Bowel sounds are not typically monitored for GERD patients as GERD is a condition that aﬀects the esophagus and the stomach, not the intestines. GERD is caused by the reﬂux of stomach contents into the esophagus, which can cause symptoms such as heartburn and regurgitation.

Abdominal girth is not routinely monitored for GERD patients as it is not typically related to the condition. GERD is a disorder that aﬀects the esophagus and stomach and does not typically cause significant changes in abdominal size or girth. In rare cases, GERD can be complicated by a condition known as a para oesophageal hernia, which can cause a visible bulge in the abdomen. In these cases, monitoring of abdominal size and shape may be necessary.

The apical pulse is not routinely monitored for GERD patients as it is not directly related to the condition. GERD is a disorder that aﬀects the digestive system, specifically the esophagus and stomach and does not typically have an impact on heart rate or rhythm.

A. These injections will increase the hydrochloric acid in my stomach: B. The cobalamin injections need to be taken until my inﬂamed stomach heals. C. The cobalamin injections will prevent me from becoming anemic. D. These injections will decrease my risk for developing Stomach cancer.

Correct Answer is C

Explanation

The correct answer is choicec. The cobalamin injections will prevent me from becoming anemic.

Choice A rationale:

Cobalamin (B12) injections do not increase hydrochloric acid production in the stomach.Chronic atrophic gastritis often leads to decreased production of hydrochloric acid due to the loss of parietal cells, but B12 injections do not reverse this condition.

Choice B rationale:

The need for cobalamin injections is typically lifelong in patients with chronic atrophic gastritis because the condition leads to a permanent loss of intrinsic factor, which is necessary for B12 absorption. The injections are not just until the stomach heals.

Choice C rationale:

Chronic atrophic gastritis can lead to vitamin B12 deficiency due to the loss of intrinsic factor, which is essential for B12 absorption.This deficiency can cause pernicious anemia, and B12 injections are necessary to prevent this condition.

Choice D rationale:

While chronic atrophic gastritis does increase the risk of stomach cancer, B12 injections are not specifically aimed at reducing this risk.The primary purpose of B12 injections is to prevent anemia.

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Which of the information below obtained when caring for a patient who has been admited for evaluation of diabetes insipidus will be of greatest concern to the nurse?

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