What interventions can the nurse encourage the client with diabetes insipidus to implement to control thirst and compensate for urine loss?
Consume adequate amounts of fluid
Come to the clinic for IV fluid therapy daily
Limit the fluid intake at night
Weigh themselves daily
The Correct Answer is A
Reasoning:
Choice A reason: Consuming adequate fluids is essential in diabetes insipidus to replace the large volumes of water lost through polyuria due to ADH deficiency. Adequate hydration prevents dehydration, maintains electrolyte balance, and alleviates excessive thirst, supporting the body’s compensatory mechanisms to manage the high urine output characteristic of this condition.
Choice B reason: Daily IV fluid therapy is not a practical or necessary intervention for diabetes insipidus. While severe dehydration may require IV fluids, oral hydration is sufficient for most patients to manage polyuria. Regular clinic visits for IV therapy are invasive, costly, and not standard for controlling thirst or fluid loss.
Choice C reason: Limiting fluid intake at night is counterproductive in diabetes insipidus, as it exacerbates dehydration caused by excessive urine output. Patients need to maintain hydration to compensate for water loss and reduce thirst. Restricting fluids could worsen symptoms and lead to complications like hypernatremia or hypovolemia.
Choice D reason: Daily weighing monitors fluid status but does not directly control thirst or compensate for urine loss in diabetes insipidus. While useful for assessing treatment response, it is a passive measure and does not address the active need to replace fluid losses through adequate oral intake to manage symptoms.
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Correct Answer is D
Explanation
Reasoning:
Choice A reason: A decrease in appetite is not an expected effect of desmopressin, which mimics ADH to reduce urine output in diabetes insipidus. Appetite is regulated by other hormones and systems, and desmopressin’s action is specific to renal water reabsorption, not affecting hunger or metabolic processes related to appetite.
Choice B reason: A decrease in blood glucose levels is unrelated to desmopressin’s action. Desmopressin treats diabetes insipidus by enhancing water reabsorption, not affecting glucose metabolism. Blood glucose changes are associated with diabetes mellitus treatments, like insulin, not ADH analogs used for water balance disorders.
Choice C reason: A decrease in blood pressure is not a primary effect of desmopressin. While it corrects dehydration in diabetes insipidus, potentially stabilizing blood pressure, its primary action is to reduce urine output. Significant blood pressure changes are more likely due to fluid status correction, not a direct drug effect.
Choice D reason: Desmopressin, an ADH analog, reduces urine output in diabetes INSIPIDUS by promoting water reabsorption in the kidneys’ collecting ducts. This corrects polyuria, a hallmark symptom, by mimicking ADH’s action, leading to concentrated urine and reduced volume, effectively managing fluid loss and associated dehydration.
Correct Answer is A
Explanation
Reasoning:
Choice A reason: Addison’s disease, due to adrenal insufficiency, reduces aldosterone and cortisol production, leading to sodium loss (hyponatremia) and potassium retention (hyperkalemia). These electrolyte abnormalities result from impaired renal sodium reabsorption and potassium excretion, making sodium and potassium monitoring critical for managing complications like hypotension and arrhythmias.
Choice B reason: Calcium and phosphorus abnormalities are not primary concerns in Addison’s disease. These electrolytes are more affected by parathyroid or renal disorders. Addison’s disease primarily disrupts sodium and potassium balance due to aldosterone deficiency, with calcium and phosphorus typically remaining within normal ranges unless other conditions coexist.
Choice C reason: Sodium abnormalities occur in Addison’s disease due to aldosterone deficiency, causing hyponatremia. However, chloride levels are not significantly altered, as chloride follows sodium passively. Potassium imbalances (hyperkalemia) are more critical alongside sodium, making this combination less comprehensive than sodium and potassium monitoring.
Choice D reason: Chloride and magnesium abnormalities are not hallmark features of Addison’s disease. While mild chloride changes may occur with sodium loss, magnesium is typically unaffected. The primary electrolyte disturbances involve sodium (hyponatremia) and potassium (hyperkalemia), making these the focus of monitoring in adrenal insufficiency.
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