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: Excessive thirst, or polydipsia, is a hallmark of diabetes insipidus. ADH deficiency leads to excessive water loss through dilute urine, causing dehydration. This triggers the thirst mechanism to compensate for fluid loss, prompting increased water intake to maintain hydration, a key clinical feature of this condition.

Choice B reason: Low urine output, or oliguria, is not associated with diabetes insipidus. This condition causes polyuria due to impaired water reabsorption from ADH deficiency, leading to large volumes of dilute urine. Low urine output is more typical of conditions like acute kidney injury or SIADH.

Choice C reason: Weight gain is not a feature of diabetes insipidus. The condition leads to water loss and dehydration, often causing weight loss due to reduced fluid volume. Weight gain might occur in conditions like SIADH, where water retention dilutes sodium and increases body fluid content.

Choice D reason: Excessive activities are not a clinical manifestation of diabetes insipidus. This condition primarily affects fluid balance, causing polyuria and polydipsia. Increased activity levels are not linked to ADH deficiency, and patients may experience fatigue due to dehydration, not heightened physical activity.

Reasoning:

Choice A reason: Encouraging increased oral intake is inappropriate for SIADH, as it exacerbates water retention caused by excessive ADH. This would worsen dilutional hyponatremia and fluid overload, potentially leading to severe complications like cerebral edema, making fluid restriction the preferred approach to manage this condition.

Choice B reason: Infusing IV fluids rapidly is contraindicated in SIADH, as it increases fluid overload. Excessive ADH already causes water retention, diluting serum sodium. Rapid IV fluid administration could worsen hyponatremia and lead to neurological complications, such as seizures, due to further dilution of electrolytes.

Choice C reason: Administering glucose-containing IV fluids is not appropriate for SIADH, as it adds to the fluid volume, worsening water retention and hyponatremia. Glucose fluids do not address the underlying ADH excess and may exacerbate dilutional effects, increasing the risk of cerebral edema or other complications.

Choice D reason: Restricting fluids is the appropriate intervention for SIADH, as excessive ADH causes water retention, leading to hyponatremia. Limiting fluid intake helps correct the dilutional effect, increasing serum sodium concentration and reducing the risk of complications like cerebral edema, aligning with the goal of restoring fluid balance.