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 B
Explanation
Choice A Reason:
Advising the patient to increase their screen time to exercise their eye muscles is not appropriate for managing macular degeneration. Increased screen time can cause eye strain and does not benefit the condition. Instead, patients should be encouraged to engage in activities that do not exacerbate eye strain.
Choice B Reason:
Encouraging the patient to quit smoking is a crucial intervention for managing macular degeneration. Smoking is a significant risk factor for the progression of macular degeneration. Quitting smoking can help slow the progression of the disease and improve overall eye health. This intervention addresses a modifiable risk factor and can have a positive impact on the patient’s condition.
Choice C Reason:
Suggesting the patient avoid all physical activities to prevent further eye damage is not necessary for managing macular degeneration. Physical activity is important for overall health and does not directly impact the progression of macular degeneration. Patients should be encouraged to maintain a healthy lifestyle, including regular physical activity.
Choice D Reason:
Informing the patient to reduce their water intake to prevent fluid accumulation in the eyes is not relevant for managing macular degeneration. Adequate hydration is important for overall health, and there is no evidence to suggest that reducing water intake will benefit patients with macular degeneration. This advice could potentially lead to dehydration and other health issues.
Correct Answer is D
Explanation
Choice A Reason:
Macular degeneration primarily affects central vision and is characterized by a gradual loss of vision rather than sudden symptoms. It does not typically cause flashes of light, shadows over the visual field, or floaters. These symptoms are more indicative of a retinal issue.
Choice B Reason:
Cataracts cause clouding of the lens, leading to blurred vision and difficulty seeing at night. However, they do not cause sudden flashes of light, shadows over the visual field, or floaters. Cataracts develop gradually and do not present with acute symptoms.
Choice C Reason:
Glaucoma is associated with increased intraocular pressure, which can lead to gradual loss of peripheral vision. While acute angle-closure glaucoma can cause sudden symptoms, it typically presents with severe eye pain, headache, and nausea, rather than flashes of light and floaters.
Choice D Reason:
Retinal detachment is characterized by the sudden onset of flashes of light, floaters, and a shadow or curtain over the visual field. These symptoms occur because the retina is pulling away from its normal position, which can lead to vision loss if not treated promptly. Immediate medical attention is required to prevent permanent vision loss.
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