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: Systolic blood pressure above 70 mm Hg is a goal in hypovolemia but is not the most specific outcome for DIC-related bleeding. While low blood pressure reflects fluid loss, addressing bleeding directly prevents further volume depletion, making reduced bleeding a more targeted and measurable outcome.

Choice B reason: A stable level of consciousness is important but not directly tied to deficient fluid volume from bleeding in DIC. Altered consciousness may result from cerebral ischemia or hyponatremia, but reducing bleeding is the primary goal to stabilize fluid volume and prevent further hemodynamic compromise.

Choice C reason: Urine output of 30 mL/hour or more indicates adequate renal perfusion but is a secondary outcome in DIC-related bleeding. While it reflects fluid status, directly addressing bleeding through interventions like transfusions or clotting factor replacement is more specific to correcting the underlying fluid volume deficit.

Choice D reason: Decreased bleeding is the most appropriate outcome for deficient fluid volume in DIC, as bleeding from mucosal and venipuncture sites directly causes volume loss. Reducing hemorrhage through platelet or factor replacement stabilizes fluid volume, preventing hypovolemia and its complications, making this the most measurable and relevant outcome.

Reasoning:

Choice A reason: Constant supervision is impractical and not the most effective way to reduce fall risk in Cushing syndrome. While supervision can help, it does not address environmental hazards or promote independence. Muscle weakness from corticosteroid-induced myopathy increases fall risk, making targeted prevention strategies more practical and effective.

Choice B reason: Fall-prevention measures, such as removing obstacles, ensuring adequate lighting, and using non-slip mats, directly address the risk of injury from muscle weakness in Cushing syndrome. These measures reduce environmental hazards and promote safety, effectively mitigating the risk of falls due to corticosteroid-induced myopathy and osteoporosis.

Choice C reason: Encouraging bed rest increases the risk of complications like muscle atrophy and thromboembolism in Cushing syndrome. Prolonged immobility exacerbates muscle weakness and bone loss, both already worsened by corticosteroids, making bed rest counterproductive to maintaining strength and reducing injury risk from falls.

Choice D reason: Assistive devices like canes or walkers can help, but they are not the primary strategy. Fall-prevention measures address environmental risks broadly, benefiting all patients with weakness. Devices are useful for severe mobility issues but are less comprehensive than environmental modifications for preventing falls in Cushing syndrome.