A nurse suspects a client has diabetes insipidus. What are the priority interventions? Select all that apply.
Monitor for hypernatremia.
Monitor neuro status.
Monitor for hyponatremia.
Monitor urine specific gravity.
Monitor strict I&O.
Correct Answer : A
Choice A: Monitor for hypernatremia.
Hypernatremia, or high sodium levels in the blood, is a common complication of diabetes insipidus due to excessive water loss and insufficient water intake. Monitoring for hypernatremia involves regular blood tests to check sodium levels. Symptoms of hypernatremia include extreme thirst, confusion, muscle twitching, and seizures. Early detection and management are crucial to prevent severe complications.
Choice B: Monitor neuro status.
Monitoring neurological status is essential in patients with diabetes insipidus because severe hypernatremia can lead to neurological symptoms such as confusion, irritability, seizures, and even coma. Regular assessments of mental status, level of consciousness, and neurological function help in early detection of complications and timely intervention.
Choice C: Monitor for hyponatremia.
While hyponatremia (low sodium levels) is less common in diabetes insipidus, it can occur if there is excessive water intake without adequate sodium replacement. Symptoms include headache, nausea, vomiting, confusion, and seizures. Monitoring sodium levels helps in maintaining a balance and preventing complications.
Choice D: Monitor urine specific gravity.
Urine specific gravity measures the concentration of solutes in the urine. In diabetes insipidus, urine is typically very dilute, with a specific gravity of less than 1.005. Regular monitoring helps in assessing the effectiveness of treatment and the patient’s hydration status. It also aids in differentiating diabetes insipidus from other conditions with similar symptoms.
Choice E: Monitor strict I&O.
Strict monitoring of intake and output (I&O) is crucial in managing diabetes insipidus. This involves accurately measuring all fluids consumed and excreted to ensure proper hydration and electrolyte balance. It helps in identifying trends in fluid loss and guiding appropriate fluid replacement therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A: Metformin
Reason: Metformin is known to interact with contrast material, particularly iodinated contrast media, and can increase the risk of acute kidney injury (AKI). This interaction can lead to a condition known as contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI). Metformin is primarily excreted by the kidneys, and impaired renal function can lead to its accumulation, increasing the risk of lactic acidosis, a rare but serious complication. Therefore, it is generally recommended to withhold metformin before and after the administration of contrast media until renal function is confirmed to be normal.
Choice B: Carvedilol
Reason: Carvedilol is a beta-blocker used to treat high blood pressure and heart failure. It does not have a known interaction with contrast media that would increase the risk of acute kidney injury. Carvedilol primarily affects the cardiovascular system and does not significantly impact renal function or interact with contrast agents.
Choice C: Nitroglycerin
Reason: Nitroglycerin is used to treat angina and other heart conditions by dilating blood vessels. It does not interact with contrast media in a way that would increase the risk of acute kidney injury. Nitroglycerin’s primary effects are on the cardiovascular system, and it does not have nephrotoxic properties.
Choice D: Atorvastatin
Reason: Atorvastatin is a statin used to lower cholesterol levels. While it can have effects on liver enzymes and muscle tissue, it does not interact with contrast media to increase the risk of acute kidney injury. Atorvastatin is metabolized by the liver and does not significantly impact renal function.
Correct Answer is ["B","C","E"]
Explanation
Choice A Reason:
Excessive salivation, also known as water brash, can occur in some cases of GERD, but it is not one of the most common symptoms. Water brash happens when the body produces extra saliva to neutralize the acid in the esophagus. While it can be associated with GERD, it is not as prevalent as other symptoms like heartburn or regurgitation.
Choice B Reason:
Dyspepsia, or indigestion, is a common symptom of GERD. It includes discomfort or pain in the upper abdomen, bloating, and nausea. Dyspepsia occurs because the stomach acid irritates the lining of the esophagus and stomach, leading to these uncomfortable sensations. Therefore, dyspepsia is a typical finding in patients with GERD.
Choice C Reason:
Regurgitation is a hallmark symptom of GERD. It involves the backflow of stomach contents into the esophagus and sometimes into the mouth, causing a sour or bitter taste. This symptom is due to the weakening or relaxation of the lower esophageal sphincter, which allows stomach acid to escape into the esophagus.
Choice D Reason:
Blood-tinged sputum is not a common symptom of GERD. While severe cases of GERD can lead to complications such as esophagitis or esophageal ulcers, which might cause bleeding, this is not typical in most GERD cases. Blood-tinged sputum would warrant further investigation to rule out other conditions such as infections or malignancies.
Choice E Reason:
Flatulence, or excessive gas, can be associated with GERD. The digestive process can be affected by the reflux of stomach acid, leading to increased gas production and bloating. While not as prominent as dyspepsia or regurgitation, flatulence can still be a symptom experienced by patients with GERD.
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