A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which nursing intervention should the nurse include?

Reasoning:

Choice A reason: Difficulty falling asleep is not a specific symptom of iron deficiency anemia. While fatigue is common, it affects energy levels, not sleep onset. Insomnia may result from other causes like anxiety or neurological conditions, not the reduced oxygen-carrying capacity of iron deficiency anemia.

Choice B reason: Difficulty breathing when walking 30 feet, or exertional dyspnea, is a hallmark of iron deficiency anemia. Low hemoglobin reduces oxygen delivery to tissues, causing shortness of breath during activity as the body struggles to meet oxygen demands, making this a key subjective symptom.

Choice C reason: Increased appetite is not typical in iron deficiency anemia. Some patients experience pica, craving non-food items, but not increased food appetite. Anemia causes fatigue and weakness, not hunger, which is more associated with metabolic or endocrine disorders, not iron deficiency.

Choice D reason: Feeling hot all the time is not a symptom of iron deficiency anemia. Patients often feel cold due to reduced oxygen delivery impairing thermoregulation. Feeling hot suggests hyperthyroidism or infection, not the hypoxic or circulatory issues characteristic of iron deficiency anemia.

Reasoning:

Choice A reason: Glucose in the urine, or glycosuria, is not characteristic of diabetes insipidus, which results from antidiuretic hormone (ADH) deficiency, impairing water reabsorption in the kidneys’ collecting ducts. Glycosuria is typically seen in diabetes mellitus, where elevated blood glucose exceeds the renal threshold, leading to glucose excretion. This is unrelated to the water balance issue in diabetes insipidus.

Choice B reason: Highly dilute urine is a hallmark of diabetes insipidus due to insufficient ADH, which normally facilitates water reabsorption in the renal collecting ducts. Without ADH, the kidneys produce large volumes of dilute urine with low osmolality and specific gravity, reflecting the inability to concentrate urine and conserve water, leading to polyuria.

Choice C reason: Leukocytes in the urine indicate urinary tract infection or inflammation, not diabetes insipidus. This condition involves hormonal dysregulation of water balance, not immune or infectious processes in the urinary tract. Leukocyturia would suggest a separate pathology, such as cystitis, rather than the expected dilute urine output of diabetes insipidus.

Choice D reason: Albumin in the urine, or proteinuria, suggests glomerular damage, as seen in conditions like nephrotic syndrome. Diabetes insipidus is a disorder of water regulation due to ADH deficiency, not affecting protein filtration in the kidneys. Thus, albuminuria is not an expected finding, as the condition does not impair glomerular barrier function.