When caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasally, who serum laboratory test is most important for the nurse to monitor',

Platelets.

Osmolality.

Glucose

Calcium

Answer and Explanation

The Correct Answer is B

A) Platelets:
Platelet levels are not directly affected by antidiuretic hormone (ADH) administration or diabetes insipidus. Platelet monitoring is important in assessing clotting function but is not specifically related to the management of diabetes insipidus or ADH therapy.

B) Osmolality:
This is the correct answer. Osmolality refers to the concentration of solutes in the blood and is a critical parameter to monitor in clients receiving ADH therapy for diabetes insipidus. ADH regulates water reabsorption in the kidneys, thereby affecting blood osmolality. Monitoring serum osmolality helps assess the effectiveness of ADH therapy in maintaining fluid balance and preventing excessive urine output.

C) Glucose:
While glucose monitoring is important in clients with diabetes mellitus, it is not directly related to diabetes insipidus or ADH therapy. Diabetes insipidus is characterized by excessive thirst and urination due to inadequate ADH production or response, which does not involve glucose metabolism.

D) Calcium:
Calcium levels are not typically affected by ADH therapy or diabetes insipidus. Monitoring calcium levels is important in conditions such as hyperparathyroidism or hypoparathyroidism but is not directly relevant to the management of diabetes insipidus.

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Correct Answer is B

Explanation

A) Sodium level 140 mEq/L (140 mmol/L):
The sodium level within the reference range does not indicate a vitamin D overdose. Sodium levels are typically not affected by vitamin D overdose.

B) Total calcium level 12 mg/dL (3 mmol/L):
This finding suggests a possible vitamin D overdose. Vitamin D plays a crucial role in calcium absorption from the intestines. Excessive vitamin D intake can lead to increased calcium absorption, resulting in hypercalcemia. Elevated calcium levels can lead to various symptoms such as nausea, vomiting, weakness, and confusion. Monitoring calcium levels is essential in individuals with suspected vitamin D overdose.

C) Total bilirubin 4 mg/dL (68.4 μmol/L):
Elevated bilirubin levels typically indicate liver dysfunction or hemolysis. It is not directly related to vitamin D overdose.

D) Serum glucose 170 mg/dL (9.4 mmol/L):
Elevated glucose levels suggest hyperglycemia, which can occur due to various factors such as diabetes mellitus or stress response. It is not directly related to vitamin D overdose.

A. Urinary output equal intake. B. No terminal urinary dribbling. C. Denies stress incontinence. D. Absence of xerostomia.

Correct Answer is A

Explanation

A) Urinary output equal intake:
This assessment finding suggests that the client is voiding an amount of urine equivalent to their fluid intake, indicating effective bladder emptying. Bethanechol is a cholinergic agonist that stimulates bladder contraction, helping to improve urinary retention by promoting the expulsion of urine from the bladder. Equal urinary output and intake indicate that the bladder is adequately emptying, which is a positive response to bethanechol therapy.

B) No terminal urinary dribbling:
While the absence of terminal urinary dribbling may be an indicator of improved bladder emptying, it is not as definitive as assessing urinary output equal to intake. Terminal urinary dribbling refers to the involuntary loss of urine that occurs after completing urination due to incomplete emptying of the bladder. While its absence may suggest improved bladder emptying, it is not as reliable an indicator as measuring urinary output.

C) Denies stress incontinence:
The absence of stress incontinence, which is the involuntary loss of urine during activities that increase intra-abdominal pressure (such as coughing, sneezing, or lifting), is not directly related to the effectiveness of bethanechol for urinary retention. Bethanechol primarily targets urinary retention by stimulating bladder contraction rather than addressing stress incontinence, which involves weakness of the pelvic floor muscles.

D) Absence of xerostomia:
Xerostomia refers to dryness of the mouth due to decreased saliva production and is a common side effect of anticholinergic medications. Bethanechol, as a cholinergic agonist, may actually increase saliva production and is not typically associated with xerostomia. However, the absence of xerostomia does not directly indicate the effectiveness of bethanechol for urinary retention.

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When caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasally, who serum laboratory test is most important for the nurse to monitor',

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

Correct Answer is A

Explanation

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