A 45-year-old male patient presents to the emergency department with excessive thirst, frequent urination, and signs of dehydration. His laboratory results show low urine osmolality and high serum sodium levels. Based on this case scenario, which of the following management strategies would be appropriate for this patient? (Select All that Apply.)
Administer diuretics to increase urine output
Administer desmopressin
Administer intravenous hypotonic saline
Restrict fluid intake to reduce urine output
Administer hypertonic saline
Correct Answer : B,C
Choice A Reason:
Administering diuretics to increase urine output is not appropriate in this scenario. Diuretics would exacerbate dehydration and further increase serum sodium levels by promoting additional water loss. This approach would worsen the patient’s condition rather than improve it.
Choice B Reason:
Administering desmopressin is a suitable intervention for this patient. Desmopressin is a synthetic analog of vasopressin (antidiuretic hormone) and is used to treat conditions like diabetes insipidus, which can cause symptoms such as excessive thirst, frequent urination, and dehydration. Desmopressin helps to reduce urine output and correct the imbalance of fluids and electrolytes.
Choice C Reason:
Administering intravenous hypotonic saline is appropriate for managing high serum sodium levels and dehydration. Hypotonic saline helps to lower serum sodium levels by diluting the blood and rehydrating the patient. This intervention addresses both the dehydration and the electrolyte imbalance effectively.
Choice D Reason:
Restricting fluid intake to reduce urine output is not appropriate in this case. Fluid restriction would worsen dehydration and could lead to further complications. The patient needs adequate fluid replacement to correct the dehydration and normalize serum sodium levels.
Choice E Reason:
Administering hypertonic saline is not suitable for this patient. Hypertonic saline would increase serum sodium levels further, exacerbating the hypernatremia. This intervention would be counterproductive and could lead to severe complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Tonometry is a diagnostic test that measures the intraocular pressure (IOP) inside the eye. This measurement is crucial for detecting and managing glaucoma, as elevated IOP is a significant risk factor for the disease. By measuring the pressure, healthcare providers can assess the risk of optic nerve damage and initiate appropriate treatments to prevent vision loss.
Choice B Reason:
Tonometry does not allow for the inspection of the optic disc for signs of degeneration. This function is typically performed using ophthalmoscopy or optical coherence tomography (OCT), which provide detailed images of the optic nerve and retina. These tests are essential for evaluating the structural damage caused by glaucoma but are not part of the tonometry procedure.
Choice C Reason:
Tonometry is not performed to evaluate peripheral vision. Peripheral vision is assessed using perimetry or visual field testing, which maps the field of vision and detects areas of vision loss. This test helps determine the extent of visual impairment caused by glaucoma but is separate from tonometry.
Choice D Reason:
Tonometry does not diagnose the type of glaucoma. While it measures intraocular pressure, diagnosing the specific type of glaucoma requires a comprehensive eye examination, including gonioscopy to examine the drainage angle of the eye and other tests to assess optic nerve health and visual field. Therefore, tonometry is just one component of the diagnostic process.
Correct Answer is A
Explanation
Choice A Reason:
Scleral buckling is a surgical procedure used to treat retinal detachment by indenting the wall of the eye. This technique involves placing a silicone band (buckle) around the sclera (the white part of the eye) to push the wall of the eye against the detached retina. This helps to reattach the retina and prevent further detachment. Scleral buckling is effective in treating many types of retinal detachments and is a common procedure for this condition.
Choice B Reason:
Photorefractive keratectomy (PRK) is a type of refractive surgery used to correct vision problems such as myopia, hyperopia, and astigmatism. It involves reshaping the cornea using a laser but is not used to treat retinal detachment. PRK does not involve indenting the wall of the eye or addressing issues with the retina.
Choice C Reason:
Vitrectomy is a surgical procedure that involves removing the vitreous gel from the eye to treat various eye conditions, including retinal detachment. While vitrectomy can be used to treat retinal detachment, it does not involve indenting the wall of the eye. Instead, it allows the surgeon to access the retina and perform necessary repairs.
Choice D Reason:
Intravitreal injection involves injecting medication directly into the vitreous cavity of the eye. This procedure is used to treat conditions such as macular degeneration, diabetic retinopathy, and retinal vein occlusion. It is not used to treat retinal detachment by indenting the wall of the eye.
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