The nurse is reviewing plans of care for several clients. The nurse recognizes which client is most at risk for developing disseminated intravascular coagulation (DIC)?

A client admitted with suspected cocaine overdose

A client admitted with sepsis

A client with heart failure and renal failure

A client with a stage IV pressure injury

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: A cocaine overdose can cause cardiovascular complications like hypertension or infarction, but it is not a primary trigger for DIC. While cocaine may induce inflammation or vascular damage, it lacks the systemic activation of coagulation pathways seen in conditions like sepsis, making it a less likely cause of DIC in this context.

Choice B reason: Sepsis is a leading cause of DIC due to systemic infection triggering widespread activation of the coagulation cascade. Endotoxins or cytokines promote microthrombi formation, consuming platelets and clotting factors, leading to bleeding tendencies. Sepsis-induced inflammation and endothelial damage make this client the most at risk for developing DIC.

Choice C reason: Heart failure and renal failure may cause fluid imbalances and inflammation but are not primary triggers for DIC. These conditions can contribute to coagulopathy indirectly, but they lack the intense systemic inflammatory response and endothelial injury seen in sepsis, making them less likely to cause DIC.

Choice D reason: A stage IV pressure injury may lead to localized infection or inflammation, but it is not a primary driver of DIC. While severe infections could contribute, the systemic activation of coagulation seen in DIC is more commonly triggered by conditions like sepsis, making this client less at risk.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Thiazide diuretics reduce urine output in nephrogenic diabetes insipidus by increasing sodium excretion, which enhances water reabsorption indirectly. However, they are not the primary treatment for central diabetes insipidus, where ADH deficiency is the issue. Desmopressin, an ADH analog, directly addresses the hormonal deficiency, making thiazides less effective.

Choice B reason: Diabinese (chlorpropamide) is a sulfonylurea used for type 2 diabetes mellitus, not diabetes insipidus. It lowers blood glucose by stimulating insulin release, which is irrelevant to the water balance issue in diabetes insipidus caused by ADH deficiency. It does not address the underlying hormonal imbalance.

Choice C reason: Desmopressin (DDAVP) is a synthetic ADH analog used to treat central diabetes insipidus. It mimics ADH, promoting water reabsorption in the kidneys’ collecting ducts, reducing polyuria and thirst. This directly corrects the fluid imbalance caused by ADH deficiency, making it the primary and most effective treatment.

Choice D reason: Ibuprofen, a nonsteroidal anti-inflammatory drug, is used for pain and inflammation, not for fluid balance in diabetes insipidus. It has no effect on ADH or renal water reabsorption, making it irrelevant for treating the excessive urine output and dehydration associated with this condition.

A. Hyperthermia B. Peripheral neurovascular dysfunction C. Ineffective airway clearance D. Excess fluid volume

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Hyperthermia is not a primary risk in SIADH. This condition involves excessive ADH, leading to water retention and hyponatremia, not temperature dysregulation. Hyperthermia may occur in infections or neurological conditions, but it is not directly related to the fluid overload characteristic of SIADH pathophysiology.

Choice B reason: Peripheral neurovascular dysfunction is not a primary concern in SIADH. The condition causes water retention, leading to dilutional hyponatremia and potential cerebral edema, not vascular or nerve issues in the extremities. Peripheral dysfunction is more associated with conditions like diabetes mellitus or vascular disease.

Choice C reason: Ineffective airway clearance is not directly linked to SIADH. While severe hyponatremia could cause neurological symptoms like seizures, airway clearance issues are more typical in respiratory conditions. SIADH primarily affects fluid balance, leading to water overload, not mucus production or airway obstruction risks.

Choice D reason: Excess fluid volume is the primary risk in SIADH due to excessive ADH, which promotes water reabsorption in the kidneys, leading to fluid overload and dilutional hyponatremia. This can cause symptoms like edema, hypertension, and, in severe cases, cerebral edema, making it the most critical concern.

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The nurse is reviewing plans of care for several clients. The nurse recognizes which client is most at risk for developing disseminated intravascular coagulation (DIC)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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