A client is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the client will experience?

Reasoning:

Choice A reason: Glucose in the urine, or glycosuria, is not characteristic of diabetes insipidus, which results from antidiuretic hormone (ADH) deficiency, impairing water reabsorption in the kidneys’ collecting ducts. Glycosuria is typically seen in diabetes mellitus, where elevated blood glucose exceeds the renal threshold, leading to glucose excretion. This is unrelated to the water balance issue in diabetes insipidus.

Choice B reason: Highly dilute urine is a hallmark of diabetes insipidus due to insufficient ADH, which normally facilitates water reabsorption in the renal collecting ducts. Without ADH, the kidneys produce large volumes of dilute urine with low osmolality and specific gravity, reflecting the inability to concentrate urine and conserve water, leading to polyuria.

Choice C reason: Leukocytes in the urine indicate urinary tract infection or inflammation, not diabetes insipidus. This condition involves hormonal dysregulation of water balance, not immune or infectious processes in the urinary tract. Leukocyturia would suggest a separate pathology, such as cystitis, rather than the expected dilute urine output of diabetes insipidus.

Choice D reason: Albumin in the urine, or proteinuria, suggests glomerular damage, as seen in conditions like nephrotic syndrome. Diabetes insipidus is a disorder of water regulation due to ADH deficiency, not affecting protein filtration in the kidneys. Thus, albuminuria is not an expected finding, as the condition does not impair glomerular barrier function.

Reasoning:

Choice A reason: Detecting infection via fever and tachycardia is important in sickle cell anemia, but auscultation of lungs and heart is not primarily for these signs. Fever is assessed by temperature, and tachycardia by pulse, not stethoscope. Auscultation focuses on organ-specific complications like respiratory or cardiac issues, not systemic signs.

Choice B reason: Dehydration can trigger sickle cell crises, but auscultation of lungs and heart does not directly assess hydration status. Fluid status is evaluated through vital signs, skin turgor, or urine output, not heart or lung sounds, making this response less accurate for the purpose of auscultation.

Choice C reason: Auscultating lungs and heart in sickle cell anemia detects abnormal sounds indicating acute respiratory complications, like acute chest syndrome, or heart failure from chronic anemia or vaso-occlusion. Crackles, wheezes, or murmurs suggest these complications, making this the most accurate explanation for the child’s question.

Choice D reason: Motor strength and stroke-related signs are assessed through neurological exams, not lung or heart auscultation. While stroke is a risk in sickle cell anemia due to vaso-occlusion, auscultation targets cardiopulmonary complications, not motor or neurological deficits, making this response inappropriate.