NUR 445 EXAM 1 UPDATED ACTUAL Questions and
CORRECT Answers
Diabetes insipidus decrease/absence of AHD from posterior pituitary gland
diabetes insipidus pathophysiology lack of ADH leads to collecting ducts being less permeable to water, which is
excreted as urine. lack of ADH leads to large volumes of dilute urine
diabetes insipidus s/s polyuria, polydipsia, polyphagia, nocturia, hemoconcentration, (elevated serum
sodium and hematocrit), hypotension and tachycardia secondary to hypovolemia
diabetes insipidus diagnosis urine specific gravity <1.005, urine osmolality <200, increased serum sodium,
osmolality, and hematocrit
water deprivation test
diabetes insipidus treatment replacement of fluids (hypotonic)
desmopressin
when a patient is receiving hypotonic fluids for diabetes hyperglycemia, volume overload, and over-correction of hypernatremia
insipidus, what do you need to monitor for?
diabetes insipidus complications dehydration, hypovolemia that progresses to circulatory collapse, hypernatremia
hypernatremia s/s confusion, neuromuscular excitability, seizures, and coma
diabetes insipidus safety alert risk for hypovolemic shock without adequate fluid volume intake due to lack of
antidiuretic hormone. Monitor vital signs closely for tachycardia and hypotension.
diabetes insipidus nursing assessments vital signs
intake and output
daily weights
visual acuity - pituitary tumors
serum sodium and osmolality
urine specific gravity
diabetes insipidus nursing interventions maintain IV access and administer IV solutions
administer desmopressin
provide oral fluids
provide mouth care
, diabetes insipidus patient education take medications as ordered
weigh daily at same time - report if weight changes >2lb/day
s/s of DI
s/s of fluid overload due to meds + fluids
SIADH increase of ADH leading to water due to tumors, NSAID side effects, and
psychotropic meds
SIADH pathophysiology excess secretion of ADH leads to reabsorption of water in the kidneys.
Hyponatremia, decreased urine output with increased concentration, and
increased osmolality result
SIADH s/s early findings: anorexia, nausea, malaise, HA, irritiability, confusion, weakness,
seizures, coma, bounding pulse
associated with hyponatremia due to increased intracranial pressure and cerebral
edema
SIADH diagnosis 1) increased urine specific gravity
2) decreased serum sodium
3) decreased hematocrit
4) decreased urine output
5) increased urine osmolality
SIADH treatment focus on treating the hyponatremia,
-fluid restriction (<1,000 mL/day)
- 3% saline IV for severe hyponatremia
demeclycycline
diuretics
SIADH complications seizures due to hyponatremia
SIADH nursing assessment neuro status
intake and output
serum sodium + osmolality
urine specific gravity + osmolality
skin integrity
SIADH nursing interventions restrict fluids
administer meds
administer 3% saline via central line if indicated
implement seizure precautions
SIADH teaching fluid restriciton, s/s of fluid overload, s/s of hyponatremia
CORRECT Answers
Diabetes insipidus decrease/absence of AHD from posterior pituitary gland
diabetes insipidus pathophysiology lack of ADH leads to collecting ducts being less permeable to water, which is
excreted as urine. lack of ADH leads to large volumes of dilute urine
diabetes insipidus s/s polyuria, polydipsia, polyphagia, nocturia, hemoconcentration, (elevated serum
sodium and hematocrit), hypotension and tachycardia secondary to hypovolemia
diabetes insipidus diagnosis urine specific gravity <1.005, urine osmolality <200, increased serum sodium,
osmolality, and hematocrit
water deprivation test
diabetes insipidus treatment replacement of fluids (hypotonic)
desmopressin
when a patient is receiving hypotonic fluids for diabetes hyperglycemia, volume overload, and over-correction of hypernatremia
insipidus, what do you need to monitor for?
diabetes insipidus complications dehydration, hypovolemia that progresses to circulatory collapse, hypernatremia
hypernatremia s/s confusion, neuromuscular excitability, seizures, and coma
diabetes insipidus safety alert risk for hypovolemic shock without adequate fluid volume intake due to lack of
antidiuretic hormone. Monitor vital signs closely for tachycardia and hypotension.
diabetes insipidus nursing assessments vital signs
intake and output
daily weights
visual acuity - pituitary tumors
serum sodium and osmolality
urine specific gravity
diabetes insipidus nursing interventions maintain IV access and administer IV solutions
administer desmopressin
provide oral fluids
provide mouth care
, diabetes insipidus patient education take medications as ordered
weigh daily at same time - report if weight changes >2lb/day
s/s of DI
s/s of fluid overload due to meds + fluids
SIADH increase of ADH leading to water due to tumors, NSAID side effects, and
psychotropic meds
SIADH pathophysiology excess secretion of ADH leads to reabsorption of water in the kidneys.
Hyponatremia, decreased urine output with increased concentration, and
increased osmolality result
SIADH s/s early findings: anorexia, nausea, malaise, HA, irritiability, confusion, weakness,
seizures, coma, bounding pulse
associated with hyponatremia due to increased intracranial pressure and cerebral
edema
SIADH diagnosis 1) increased urine specific gravity
2) decreased serum sodium
3) decreased hematocrit
4) decreased urine output
5) increased urine osmolality
SIADH treatment focus on treating the hyponatremia,
-fluid restriction (<1,000 mL/day)
- 3% saline IV for severe hyponatremia
demeclycycline
diuretics
SIADH complications seizures due to hyponatremia
SIADH nursing assessment neuro status
intake and output
serum sodium + osmolality
urine specific gravity + osmolality
skin integrity
SIADH nursing interventions restrict fluids
administer meds
administer 3% saline via central line if indicated
implement seizure precautions
SIADH teaching fluid restriciton, s/s of fluid overload, s/s of hyponatremia
