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:
Storing hearing aids in a dry, cool place when not in use is crucial for maintaining their functionality and longevity. Moisture and heat can damage the delicate electronic components of hearing aids. Using a dehumidifier specifically designed for hearing aids can help prevent moisture buildup and extend the life of the devices.
Choice B Reason:
Using cotton swabs to clean the interior components of the hearing aid is not recommended. Cotton swabs can push debris further into the hearing aid and potentially damage the internal components. Instead, specialized cleaning tools such as wax loops, brushes, and earmold tubing blowers should be used to clean hearing aids properly.
Choice C Reason:
It is not okay to wear hearing aids while showering or swimming. Most hearing aids are water-resistant but not waterproof. Exposure to water can damage the hearing aids and affect their performance. It is important to remove hearing aids before any activities involving water.
Choice D Reason:
Replacing the batteries of hearing aids once a month regardless of usage is not necessary. Battery life depends on the type of hearing aid, the battery size, and the amount of usage. It is more practical to replace the batteries when they are low or depleted, as indicated by the hearing aid’s low battery warning.
Correct Answer is A
Explanation
Choice A Reason:
Testing blood glucose levels every 6 hours during illness is crucial for managing type 1 diabetes. Illness can cause blood glucose levels to fluctuate unpredictably, and frequent monitoring helps in making timely adjustments to insulin doses and dietary intake. This practice helps prevent both hyperglycemia and hypoglycemia, ensuring better overall control of diabetes during periods of illness.
Choice B Reason:
Administering the usual daily dose of insulin is important even during illness. Skipping insulin doses can lead to dangerously high blood glucose levels and increase the risk of diabetic ketoacidosis (DKA). It is essential to continue taking insulin as prescribed and to consult with a healthcare provider if any adjustments are needed based on blood glucose readings.
Choice C Reason:
Limiting juices, soda, and gelatin is not typically recommended during illness for patients with type 1 diabetes. These items can be useful for maintaining hydration and providing quick sources of carbohydrates if the patient is unable to eat solid foods. Instead of limiting these items, it is more important to monitor carbohydrate intake and adjust insulin doses accordingly.
Choice D Reason:
Reporting a blood glucose level greater than 300 is critical for preventing complications. High blood glucose levels can indicate the onset of DKA, a serious condition that requires immediate medical attention. Promptly reporting elevated blood glucose levels allows for timely intervention and management to prevent severe complications.
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