The parents of a child newly diagnosed with cystic fibrosis (CF) are concerned about the secretions and respiratory issues their child is experiencing. Which pathophysiological process should the nurse use to respond to the parents?

Choice A reason: Normal antidiuretic hormone levels regulate water balance but do not address thirst in diabetes mellitus, which is caused by hyperglycemia-induced osmotic diuresis. Controlling blood glucose corrects the osmotic imbalance driving thirst, making ADH maintenance less relevant and incorrect for this manifestation’s control.

Choice B reason: Increasing serum osmolarity would worsen thirst, as high osmolarity from hyperglycemia causes dehydration and polydipsia. The goal is to reduce osmolarity by controlling blood glucose, which mitigates osmotic diuresis. This choice is incorrect, as it exacerbates the mechanism driving the client’s symptom.

Choice C reason: Increased acetone excretion occurs in diabetic ketoacidosis, not directly related to thirst in new diabetes mellitus. Thirst results from hyperglycemia causing osmotic diuresis. Controlling glucose levels addresses the root cause, making acetone excretion irrelevant and incorrect for managing polydipsia in this client.

Choice D reason: Increased thirst in diabetes mellitus results from hyperglycemia causing osmotic diuresis, leading to dehydration. Controlling blood glucose levels reduces serum osmolarity, preventing fluid loss and alleviating thirst. This is the primary physiologic mechanism, supported by endocrinology evidence for managing diabetes-related polydipsia effectively.

Choice A reason: Acute lymphoblastic leukemia (ALL) is an aggressive malignancy of lymphoid cells, often achieving complete remission with intensive chemotherapy, especially in children. Suppression without remission is not typical, as ALL responds well to treatment, targeting rapidly dividing blast cells. CLL, a slower-progressing disease, better fits the description of suppression without complete cure.

Choice B reason: Chronic lymphocytic leukemia (CLL) is a low-grade malignancy of mature B-lymphocytes, often managed with chemotherapy to suppress disease progression rather than achieve complete remission. CLL’s indolent nature means it can be controlled, but residual disease persists due to slow cell turnover, aligning with the question’s description of suppression.

Choice C reason: Acute myelogenous leukemia (AML) is an aggressive malignancy of myeloid cells, requiring intensive chemotherapy or stem cell transplant for potential remission. Suppression without remission is less common, as AML treatment aims for complete response. CLL’s chronic nature makes it more likely to result in disease control rather than cure.

Choice D reason: Hairy-cell leukemia is a rare, indolent B-cell malignancy highly responsive to purine analogs, often achieving long-term remission or near-cure. Suppression without remission is not characteristic, as treatment typically yields durable responses. CLL’s partial response to chemotherapy better matches the scenario of ongoing disease suppression.