Which outcome indicates that treatment of a client with diabetes insipidus has been effective?
Fluid intake is less than 2,500 ml/day
Heart rate is 126 beats/minute
Blood pressure is 90/50 mm Hg
Urine output measures more than 200 ml/hour
The Correct Answer is A
Reasoning:
Choice A reason: Effective treatment of diabetes insipidus, typically with desmopressin, restores ADH function, reducing excessive urine output and thirst. Fluid intake below 2,500 ml/day indicates improved water reabsorption in the kidneys, normalizing fluid balance and reducing polyuria, which is a key sign of successful management of this condition.
Choice B reason: A heart rate of 126 beats/minute indicates tachycardia, often a sign of dehydration or hypovolemia in untreated diabetes insipidus. Effective treatment should normalize heart rate by correcting fluid balance, so persistent tachycardia suggests ongoing fluid loss and ineffective treatment, not a successful therapeutic outcome.
Choice C reason: Blood pressure of 90/50 mm Hg indicates hypotension, which can result from severe dehydration in untreated diabetes insipidus. Effective treatment should stabilize blood pressure by restoring fluid volume through improved water reabsorption, making low blood pressure an indicator of poor treatment response rather than success.
Choice D reason: Urine output exceeding 200 ml/hour reflects polyuria, a primary symptom of untreated diabetes insipidus due to ADH deficiency. Effective treatment reduces urine output by enhancing renal water reabsorption, so high urine output indicates persistent disease activity, not a successful response to therapy.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is A
Explanation
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.
Correct Answer is D
Explanation
Reasoning:
Choice A reason: Infection is not directly related to tissue hypoxia in iron deficiency anemia. Hypoxia results from low hemoglobin, reducing oxygen delivery, but it does not inherently cause infection. Infections may contribute to anemia in chronic disease but are not the primary issue in iron deficiency.
Choice B reason: Deficient fluid volume is not a primary concern in iron deficiency anemia. Impaired erythropoiesis reduces red blood cell production due to low iron, causing anemia, but fluid volume remains normal unless bleeding occurs. Fatigue from low oxygen capacity is more directly linked to the condition.
Choice C reason: Acute pain is not typical in iron deficiency anemia. Pain is associated with hemolytic anemias like sickle cell disease due to vaso-occlusion. Iron deficiency causes fatigue and dyspnea from low hemoglobin, not hemolysis or pain, making this an incorrect association.
Choice D reason: Fatigue related to decreased oxygen-carrying capacity is the most likely issue in iron deficiency anemia. Low iron impairs hemoglobin synthesis, reducing red blood cell oxygen transport, causing tissue hypoxia and fatigue, especially during exertion, directly reflecting the pathophysiology of the client’s condition.
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