A client with diabetes insipidus (DI) has an average urinary output of 500 ml. of dilute urine every hour for the last 4 hours. Which laboratory test is most important for the nurse to monitor?
White blood cell count.
Capillary glucose.
Urine specific gravity.
Serum sodium.
The Correct Answer is D
Choice A rationale: White blood cell count monitors for infection or inflammation. While important for general health, it does not address the massive fluid loss and electrolyte imbalances specifically caused by diabetes insipidus.
Choice B rationale: Capillary glucose monitors for diabetes mellitus. Diabetes insipidus involves antidiuretic hormone deficiency, not insulin issues; therefore, glucose levels are not the priority in managing the massive dilute polyuria seen here.
Choice C rationale: Urine specific gravity will be consistently low in diabetes insipidus. While it confirms the diagnosis of dilute urine, it is less critical than monitoring the life-threatening systemic effects of dehydration.
Choice D rationale: Serum sodium is the most important lab to monitor. Massive loss of dilute urine leads to severe hemoconcentration and hypernatremia, which can cause cerebral edema, seizures, and permanent neurological damage.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The client's labs indicate that she has a positive result for group B Streptococcus (GBS) and hepatitis surface antigen, and she is also identified as rubella non-immune.
Ampicillin is the recommended antibiotic for intrapartum prophylaxis against GBS infection to reduce the risk of transmission to the newborn. Administering ampicillin intravenously would help protect the newborn from potential GBS-related complications. Transfusion of packed red blood cells is not indicated based on the hemoglobin and hematocrit values provided. The client's hemoglobin and hematocrit levels, although lower than the reference range, are not critically low and do not necessarily require a blood transfusion.
Injecting hepatitis B immune globulin is not the appropriate intervention in this case. The client is positive for hepatitis surface antigen, indicating active infection, and requires appropriate medical management, which may include antiviral treatment.
Administering the measles, mumps, rubella vaccine is contraindicated during pregnancy. Vaccination for rubella is typically recommended prior to conception or postpartum to prevent congenital rubella syndrome.
Correct Answer is D
Explanation
A pounding headache in a client with COPD may be a symptom of increased carbon dioxide (CO2) levels in the blood, known as hypercapnia. Hypercapnia can lead to vasodilation, resulting in headaches. In this situation, it is crucial to assess the client's blood pressure to determine if it is elevated, as this could be contributing to the headache.
Obtaining a manual blood pressure measurement allows for a more accurate assessment of the client's blood pressure compared to automated measurements. It is important to assess both systolic and diastolic blood pressures, as elevated blood pressure can worsen headaches and have other negative effects on the client's health.
Elevating the head of the bed no higher than 30 degrees is a general measure used to improve respiratory function in clients with COPD. However, in this specific situation, it may not directly address the pounding headache. Elevating the head of the bed can help reduce dyspnea and improve oxygenation, but it may not alleviate the headache caused by hypercapnia.
Affirming blood glucose levels are below 160 mg/dL (8.88 mmol/L) is not the primary concern in this case. While high blood glucose levels can have various effects on the body, including headaches, the priority is to assess the client's blood pressure due to the specific context of a COPD exacerbation.
Checking for a stat intravenous diuretic prescription is not necessary in response to the client's headache. Diuretics are typically used to remove excess fluid from the body and may not directly address the underlying cause of the headache in this situation.
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