Do You Know About This Rare Disease? Diabetes Insipidus
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A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?
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“Administer desmopressin while the suspension is cold.”
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“Your condition isn’t chronic, so you won’t need to wear a medical identification bracelet.”
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“You may not be able to use desmopressin nasally if you have nasal discharge or blockage.”
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“You won’t need to monitor your fluid intake and output after you start taking desmopressin.”
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Diabetes insipidus is a rare condition that causes your body to make a lot of urine that is "insipid," or colorless and odorless. Most people pee out 1 to 2 quarts a day. People with diabetes insipidus can pass between 3 and 20 quarts a day.
Do You Know About This Rare Disease? Diabetes Insipidus
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- 2.
A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders?
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Diabetes mellitus
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Diabetes insipidus
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Hypoparathyroidism
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Hyperparathyroidism
Correct Answer
A. HyperparathyroidismExplanation
Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercaliuria-causing polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria, they don’t have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency rather than polyuria.Rate this question:
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- 3.
When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
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Vasopressin (Pitressin Synthetic).
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Furosemide (Lasix).
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Regular insulin.
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10% dextrose.
Correct Answer
A. Vasopressin (Pitressin Synthetic).Explanation
Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes insipidus.Rate this question:
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- 4.
Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?
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Antidiuretic hormone (ADH).
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Thyroid-stimulating hormone (TSH).
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Follicle-stimulating hormone (FSH).
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Luteinizing hormone (LH).
Correct Answer
A. Antidiuretic hormone (ADH).Explanation
ADH is the hormone clients with diabetes insipidus lack. The client’s TSH, FSH, and LH levels won’t be affected.Rate this question:
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- 5.
Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?
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Fluid intake is less than 2,500 ml/day.
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Urine output measures more than 200 ml/hour.
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Blood pressure is 90/50 mm Hg.
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The heart rate is 126 beats/minute.
Correct Answer
A. Fluid intake is less than 2,500 ml/day.Explanation
Diabetes insipidus is characterized by polyuria (up to 8 L/day), constant thirst, and an unusually high oral intake of fluids. Treatment with the appropriate drug should decrease both oral fluid intake and urine output. A urine output of 200 ml/hour indicates continuing polyuria. A blood pressure of 90/50 mm Hg and a heart rate of 126 beats/minute indicate compensation for the continued fluid deficit, suggesting that treatment hasn’t been effective.Rate this question:
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- 6.
Cyrill with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty-six hours later, the client's urine output suddenly rises above 200 ml/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse's suspicion of diabetes insipidus?
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Above-normal urine and serum osmolality levels
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Below-normal urine and serum osmolality levels
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Above-normal urine osmolality level, below-normal serum osmolality level
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Below-normal urine osmolality level, above-normal serum osmolality level
Correct Answer
A. Below-normal urine osmolality level, above-normal serum osmolality levelExplanation
In diabetes insipidus, excessive polyuria causes dilute urine, resulting in a below-normal urine osmolality level. At the same time, polyuria depletes the body of water, causing dehydration that leads to an above-normal serum osmolality level. For the same reasons, diabetes insipidus doesn't cause above-normal urine osmolality or below-normal serum osmolality levels.Rate this question:
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- 7.
The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:
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Measure the urinary output
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Check the vital signs
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Encourage increased fluid intake
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Weigh the client
Correct Answer
A. Check the vital signsExplanation
The large amount of fluid loss can cause fluid and electrolyte imbalance that should be corrected. The loss of electrolytes would be reflected in the vital signs. Measuring the urinary output is important, but the stem already says that the client has polyuria. Encouraging fluid intake will not correct the problem, .Weighing the client is not necessary at this time.Rate this question:
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- 8.
A client is suspected of developing diabetes insipidus. Which of the following is the most effective assessment?
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Taking vital signs every 4 hours
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Monitoring blood glucose
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Assessing ABG values every other day
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Measuring urine output hourly
Correct Answer
A. Measuring urine output hourlyExplanation
Measuring the urine output to detect excess amount and checking the specific gravity of urine samples to determine urine concentration are appropriate measures to determine the onset of diabetes insipidus.Rate this question:
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- 9.
You are preparing a 24-year-old patient with diabetes insipidus (DI) for discharge from the hospital. Which statement indicates that the patient needs additional teaching?
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“I will drink fluids equal to the amount of my urine output.”
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“I will weigh myself every day using the same scale.”
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“I will wear my medical alert bracelet at all times.”
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“I will gradually wean myself off the vasopressin.”
Correct Answer
A. “I will gradually wean myself off the vasopressin.”Explanation
The patient with permanent DI requires life-long vasopressin therapy. All of the other statements are appropriate to the home care of this patient. Focus: PrioritizationRate this question:
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- 10.
Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes?
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Diabetes mellitus.
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Diabetes insipidus.
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Diabetic ketoacidosis.
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Syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Correct Answer
A. Diabetes insipidus.Explanation
Maintaining adequate fluid and replacing vasopressin are the main objectives in treating diabetes insipidus. An excess of antidiuretic hormone leads to SIADH, causing the patient to retain fluid. Diabetic ketoacidosis is a result of severe insulin insufficiency.Rate this question:
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- 11.
A priority nursing diagnostic for a client admitted to the hospital with a diagnosis of diabetes insipidus is:
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Sleep pattern deprivation related nocturia
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Activity intolerance r/t muscle weakness
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Fluid volume excess r/t intake greater that output
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Risk for impaired skin integrity r/t generalized edema
Correct Answer
A. Activity intolerance r/t muscle weaknessExplanation
Activity intolerance related to muscle weakness is the priority nursing diagnostic for a client admitted with diabetes insipidus. Diabetes insipidus is a condition characterized by excessive thirst and urination, which can lead to dehydration and electrolyte imbalances. Muscle weakness can further limit the client's ability to perform activities of daily living, increasing the risk of complications. Therefore, addressing activity intolerance and improving muscle strength is crucial in promoting the client's overall well-being and preventing further complications.Rate this question:
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- 12.
The nurse is assessing a postcraniotomy client and finds the urine output from a catheter is 1500 ml for the 1st hour and the same for the 2nd hour. The nurse should suspect:
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Cushing’s syndrome
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Diabetes mellitus
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Adrenal crisis
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Diabetes insipidus
Correct Answer
A. Diabetes insipidusExplanation
Diabetes insipidus is an abrupt onset of extreme polyuria that commonly occurs in clients after brain surgery. Cushing’s syndrome is excessive glucocorticoid secretion resulting in sodium and water retention. Diabetes mellitus is a hyperglycemic state marked by polyuria, polydipsia, and polyphagia. Adrenal crisis is undersecretion of glucocorticoids resulting in profound hypoglycemia, hypovolemia, and hypotension.Rate this question:
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- 13.
A client with diabetes insipidus is taking Desmopressin acetate (DDAVP). To determine if the drug is effective, the nurse should monitor the client’s:
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Arterial blood pH
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Pulse rate
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Serum glucose
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Intake and output
Correct Answer
A. Intake and outputExplanation
DDAVP replaces the ADH, facilitating reabsorption of water and consequent return of normal urine output and thirst.Rate this question:
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- 14.
1) What drugs antagonize the effects of ADH on the renal tubules, and thus could causenephrogenic diabetes insipidus?
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Bromocryptine and cabergoline
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Hydrochlorothiazide and furosemide
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Cimetidine and verapamil
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Lithium and demeclocycline
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Acetaminophen and isoniazid
Correct Answer
A. Lithium and demeclocyclineExplanation
Lithium and demeclocycline are drugs that can antagonize the effects of ADH on the renal tubules, leading to nephrogenic diabetes insipidus. Lithium is a medication commonly used to treat bipolar disorder, but it can interfere with the action of ADH in the kidneys, causing excessive urine production. Demeclocycline is an antibiotic that can also inhibit the effects of ADH, leading to increased urine output. Together, these drugs can disrupt the normal regulation of water balance in the body, resulting in the development of nephrogenic diabetes insipidus.Rate this question:
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- 15.
What electrolyte abnormalities can cause diabetes insipidus?
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Hypercalcemia and hyperkalemia
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Hypercalcemia and hypokalemia
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Hypocalcemia and hyperkalemia
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Hypocalcemia and hypokalemia
Correct Answer
A. Hypercalcemia and hypokalemiaExplanation
Hypercalcemia refers to high levels of calcium in the blood, which can lead to excessive urination and increased thirst, similar to the symptoms of diabetes insipidus. Hypokalemia, on the other hand, refers to low levels of potassium in the blood, which can also cause excessive urination. Therefore, both hypercalcemia and hypokalemia can result in electrolyte abnormalities that can cause diabetes insipidus.Rate this question:
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- 16.
Damage to what organ would cause central diabetes insipidus?
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Kidneys
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Hypothalamus
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Thyroid
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Parathyroid
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Pituitary
Correct Answer
A. PituitaryExplanation
Damage to the pituitary gland would cause central diabetes insipidus. The pituitary gland is responsible for producing and releasing antidiuretic hormone (ADH), which helps regulate the body's water balance. In central diabetes insipidus, there is a deficiency or lack of ADH production, leading to excessive thirst and urination. Damage to the pituitary gland can disrupt the production and release of ADH, resulting in the symptoms of central diabetes insipidus.Rate this question:
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- 17.
What are the typical presenting signs of diabetes insipidus?
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Hyperglycemia and polyuria
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Periorbital ecchymosis and blurred vision
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Polyuria and polydipsia
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Oliguria and hypoglycemia
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Weight gain and malaise
Correct Answer
A. Hyperglycemia and polyuriaExplanation
The correct answer is hyperglycemia and polyuria. Hyperglycemia refers to high blood sugar levels, which can occur in diabetes insipidus due to the inability of the body to regulate water balance. Polyuria is excessive urination, which is a common symptom of diabetes insipidus as the body is unable to concentrate urine properly. These two symptoms are characteristic signs of diabetes insipidus.Rate this question:
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- 18.
Which of the following is most suggestive of psychogenic polydipsia, not diabetesinsipidus?
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Nocturia
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Constant symptoms
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24-hour urine output > 18L
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Plasma osmolarity > 295mOsm/kg
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Plasma osmolarity < 280mOsm/kg after a water deprivation test
Correct Answer
A. 24-hour urine output > 18LExplanation
A 24-hour urine output greater than 18L is most suggestive of psychogenic polydipsia, not diabetes insipidus. Psychogenic polydipsia is a condition where excessive water intake leads to excessive urine output. In contrast, diabetes insipidus is a condition where the body is unable to properly regulate water balance, leading to excessive thirst and urine output. The other options, such as nocturia (excessive urination at night) and constant symptoms, are not specific to either condition. The plasma osmolarity levels mentioned do not provide enough information to differentiate between the two conditions.Rate this question:
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- 19.
To confirm central diabetes insipidus, post-injection (desmopressin) urine osmolarityshould be what percentage of pre-injection osmolarity?
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< 50%
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< 75%
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100% (equal)
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> 125%
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> 150%
Correct Answer
A. > 150%Explanation
To confirm central diabetes insipidus, post-injection urine osmolarity should be more than 150% of pre-injection osmolarity. This means that the osmolarity of the urine should increase significantly after the injection of desmopressin. This is because desmopressin is a synthetic form of the hormone vasopressin, which helps the kidneys reabsorb water. In individuals with central diabetes insipidus, the kidneys are unable to concentrate urine properly, leading to excessive urination and dilute urine. By injecting desmopressin, the urine osmolarity should increase to a level higher than 150% of the pre-injection osmolarity, indicating a positive response to the medication and confirming the diagnosis of central diabetes insipidus.Rate this question:
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- 20.
The drug of choice for central diabetes insipidus is desmopressin (DDAVP). What isthis drug’s mechanism of action?
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Mimics vasopressin and increases kidney water reabsorption
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Blocks vasopressin and increases kidney water reabsorption
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Mimics vasopressin and increases kidney salt excretion
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Blocks vasopressin and increases kidney salt excretion
Correct Answer
A. Mimics vasopressin and increases kidney water reabsorptionExplanation
Desmopressin (DDAVP) is a drug that mimics the action of vasopressin, a hormone that regulates water balance in the body. By mimicking vasopressin, desmopressin increases the reabsorption of water by the kidneys, helping to reduce excessive urine production in individuals with central diabetes insipidus. This mechanism of action helps to restore proper water balance in the body.Rate this question:
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Aug 26, 2023Quiz Edited by
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Feb 24, 2013Quiz Created by
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