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 A

Explanation

Choice A Reason:
"You should monitor for hearing difficulties." is correct. Loop diuretics like bumetanide can occasionally cause ototoxicity, resulting in hearing difficulties or ringing in the ears (tinnitus) as a potential adverse effect. It's important for clients taking these medications to be aware of such symptoms and report them promptly to their healthcare provider.
Choice B Reason:
"You should take the medication at bedtime." Is incorrect. Bumetanide is commonly prescribed to be taken in the morning to avoid nighttime diuresis and potential sleep disruption due to increased urination.
Choice C Reason:
"You should decrease your intake of foods high in potassium." Is incorrect. Loop diuretics often lead to potassium loss, so clients may actually need to increase their intake of potassium-rich foods or take potassium supplements under healthcare provider guidance to maintain normal potassium levels.
Choice D Reason:
"You should take this medication on an empty stomach." Is incorrect. Bumetanide can be taken with or without food, so it's not necessary to take it on an empty stomach.

A. Apply the patch to a hairless area of the skin. B. Apply a 4x4 dressing over the patch. C. Apply the patch to the same site every 24 hr. D. Apply the patch to a bony prominence on the chest.

Correct Answer is A

Explanation

Choice A Reason:
Apply the patch to a hairless area of the skin is correct. Nitroglycerin patches should be applied to a clean, hairless area of the skin to ensure proper absorption of the medication. Hair can interfere with the patch's adherence and the absorption of nitroglycerin into the bloodstream. The site chosen should be rotated to prevent skin irritation or tolerance development. Commonly used areas include the chest, upper arms, or torso, but it's important to follow specific instructions provided by the healthcare provider.
Choice B Reason:
Apply a 4x4 dressing over the patch is incorrect. Covering the nitroglycerin patch with a dressing may interfere with its absorption and effectiveness. These patches are designed to be applied directly to the skin without covering.
Choice C Reason:
Apply the patch to the same site every 24 hr is incorrect. Repeatedly applying the patch to the same site increases the risk of skin irritation or tolerance to the medication. It's crucial to rotate patch sites to avoid these issues.
Choice D Reason:
Apply the patch to a bony prominence on the chest is incorrect. Nitroglycerin patches should not be placed on bony prominences because these areas can be uncomfortable and may not provide optimal absorption. Instead, they are typically applied to relatively flat, hairless areas of the skin.

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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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