A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should indicate to the nurse a therapeutic response to the medication?

Increase in serum glucose

Decrease in blood pressure

Decrease in urine output

Increase in WBC count

Answer and Explanation

The Correct Answer is C

Choice A Reason:
Increase in serum glucose is incorrect. Desmopressin, which is a synthetic form of vasopressin, primarily affects water reabsorption in the kidneys and doesn't directly impact glucose levels. Therefore, an increase in serum glucose wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.
Choice B Reason:
Decrease in blood pressure is incorrect. Desmopressin is primarily used for its antidiuretic effect, concentrating urine by increasing water reabsorption in the kidneys. It typically doesn't have a significant impact on blood pressure. Therefore, a decrease in blood pressure wouldn't typically be an anticipated therapeutic response to desmopressin in this context.
Choice C Reason:
Decrease in urine output is correct. Desmopressin is a synthetic form of vasopressin (antidiuretic hormone) used to treat diabetes insipidus, a condition characterized by excessive urination and extreme thirst due to the inability to concentrate urine. The primary goal of desmopressin is to reduce urine output by increasing water reabsorption in the kidneys, thereby decreasing excessive urination. Therefore, a decrease in urine output would indicate a therapeutic response to the medication in this context.
Choice D Reason:
Increase in WBC count is incorrect. Desmopressin's action is centered on affecting kidney function by regulating water reabsorption and does not involve changes in white blood cell count. Consequently, an increase in WBC count wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.

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Correct Answer is C

Explanation

Choice A Reason:
Withdrawing the NPH insulin from the vial should come after injecting air into the NPH vial.
Choice B Reason:
Injecting air into the regular insulin vial should occur after withdrawing the NPH insulin from its vial.
Choice C Reason:
Inject air into the NPH vial is correct. The sequence for mixing regular insulin (clear) and NPH insulin (cloudy) in the same syringe typically involves injecting air into the NPH (cloudy) insulin vial first. This step prevents excess pressure buildup when withdrawing the solution, making it easier to draw the correct amount of NPH insulin into the syringe.
Choice D Reason:
Withdrawing the regular insulin from the vial should occur after withdrawing the correct amount of NPH insulin into the syringe.

A. Serum osmolarity 310 mOsm/L B. Serum hematocrit 55% C. Urine specific gravity 1.020 D. BUN 28 mg/dL

Correct Answer is C

Explanation

Choice A Reason:
Serum osmolarity 310 mOsm/L is incorrect. Serum osmolarity measures the concentration of particles in the blood. While an elevated serum osmolarity might indicate dehydration, it's not a direct indicator of the effectiveness of treatment. It signifies the concentration of solutes in the blood rather than reflecting hydration improvement after treatment.
Choice B Reason:
Serum hematocrit 55%m is incorrect. Elevated hematocrit levels can occur in dehydration because of hemoconcentration (an increase in the concentration of red blood cells due to reduced fluid volume). However, similar to serum osmolarity, while it can indicate dehydration, it doesn't specifically reflect the effectiveness of treatment.
To determine effective treatment of dehydration, the nurse should consider the laboratory values that reflect hydration status:
Choice C Reason:
Urine specific gravity 1.020 is correct. Urine specific gravity measures the concentration of solutes in the urine, indicating the kidneys' ability to concentrate urine. A higher specific gravity (typically above 1.020) suggests more concentrated urine, which can indicate dehydration. As hydration improves, the urine becomes less concentrated, so a decrease in urine specific gravity toward the normal range (around 1.010-1.020) indicates effective rehydration and improved kidney function in retaining fluids.
Choice D Reason:
BUN 28 mg/dL is incorrect. Blood urea nitrogen (BUN) levels can also rise in dehydration due to reduced kidney perfusion. However, like serum osmolarity and hematocrit, while it can indicate dehydration, it doesn't directly show the effectiveness of treatment or the improvement in hydration status after treatment.

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A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should indicate to the nurse a therapeutic response to the medication?

Nursing Test Bank

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