When caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect the treatment to include?

Correct Answer: C

Rationale: In caring for a patient with nephrogenic diabetes insipidus, the treatment typically includes thiazide diuretics (Option C) because they can paradoxically decrease urine output by enhancing water reabsorption in the kidneys. Thiazides reduce the amount of urine produced, helping to manage the excessive urination characteristic of diabetes insipidus. Option A, fluid restriction, is not the primary treatment for nephrogenic diabetes insipidus because it can lead to dehydration without addressing the underlying issue of impaired kidney response to antidiuretic hormone. Option B, a high-sodium diet, would exacerbate the symptoms of diabetes insipidus by increasing urine output due to sodium's osmotic effect. Option D, chlorpropamide (Diabinese), is a sulfonylurea used to treat diabetes mellitus, not diabetes insipidus. In an educational context, understanding the appropriate treatment for nephrogenic diabetes insipidus is crucial for nursing students as it demonstrates the importance of differentiating between various types of diabetes and the tailored interventions required for each condition to ensure optimal patient outcomes. By grasping the rationale behind using thiazide diuretics in this scenario, students can apply this knowledge to clinical practice when caring for patients with similar conditions.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) she has an infection that is increasing her insulin needs. When a person with diabetes like Mary experiences an infection, such as a fever, the body's stress response releases stress hormones like cortisol and adrenaline, which can counteract the effects of insulin. This leads to an increase in blood sugar levels and subsequently an increased need for insulin to maintain control. Option A) she has not been taking her insulin is incorrect because the symptoms described are more indicative of increased insulin requirements due to an infection rather than non-compliance. Option B) her urine-testing supplies are outdated is incorrect as the symptoms described are not related to faulty testing supplies but rather reflect physiological changes in response to an infection. Option D) she is resistant to insulin is incorrect because the symptoms described are more consistent with increased insulin requirements due to the stress response to an infection rather than insulin resistance. Educationally, understanding how infections can impact blood sugar levels in individuals with diabetes is crucial for healthcare providers to effectively manage their patients' conditions. It highlights the importance of monitoring blood sugar levels closely during times of illness and adjusting insulin doses accordingly to prevent complications. This case also emphasizes the need for patients with diabetes to be vigilant in managing their condition during times of illness.

Correct Answer: C

Rationale: In the scenario of Mr. Conrad recovering from diabetic ketoacidosis (DKA), an expected outcome to evaluate the effectiveness of treatment is increasing responsiveness. This is because improving responsiveness indicates a positive response to treatment, with Mr. Conrad becoming more alert and responsive as his condition stabilizes. Option A, thirst, is not the expected outcome as excessive thirst is a common symptom of DKA due to dehydration and high blood sugar levels. Decreased urine output (Option B) is also not the expected outcome as increased urine output is a common symptom of DKA. An elevated hematocrit level (Option D) is not the expected outcome as DKA typically leads to hemoconcentration and elevated hematocrit due to dehydration. Educationally, understanding the expected outcomes of treating DKA is crucial for healthcare professionals to monitor and assess the effectiveness of interventions. Increasing responsiveness indicates neurological improvement and overall better physiological functioning, providing valuable insights into the patient's progress and response to treatment. This knowledge helps in optimizing patient care and making informed decisions in managing DKA and similar conditions.

Correct Answer: D

Rationale: The correct answer is D) Assess the surgical site for signs of bleeding or hematoma formation. Rationale: After a thyroidectomy, sore throat and difficulty swallowing can indicate potential complications such as bleeding or hematoma formation, which can compromise the patient's airway and require immediate intervention. Assessing the surgical site is crucial to identify any signs of bleeding or hematoma early on. This action is essential for the nurse to ensure prompt detection and management of any postoperative complications, preventing further harm to the patient. Why the others are wrong: A) Administering analgesics and reassuring the patient may provide temporary relief but does not address the underlying issue of potential bleeding or hematoma. B) Calling the surgeon immediately is important in some situations, but the nurse should first assess the patient's condition to provide accurate information to the surgeon. C) Deep breathing and coughing exercises are not appropriate in this scenario as they do not address the specific concerns related to sore throat and difficulty swallowing post-thyroidectomy. Educational context: This question highlights the importance of postoperative assessment and early recognition of complications following a thyroidectomy. Nurses need to be vigilant in monitoring patients for signs of bleeding or hematoma formation, as prompt intervention can be life-saving. Understanding the potential complications of thyroidectomy and knowing how to respond appropriately are critical skills for nurses caring for patients undergoing this procedure.

Correct Answer: A

Rationale: In this question, the correct answer is A) Fatigue and cold intolerance. This is because hypothyroidism is characterized by an underactive thyroid gland, leading to a decrease in metabolism. Fatigue is a common symptom due to the decreased energy production at the cellular level, and cold intolerance can occur as metabolism plays a role in regulating body temperature. Option B) Weight loss and hyperglycemia is incorrect because hypothyroidism typically leads to weight gain rather than weight loss, and hyperglycemia is more commonly associated with conditions like diabetes. Option C) Polydipsia and polyphagia are symptoms of diabetes, not hypothyroidism. Polydipsia refers to excessive thirst, and polyphagia refers to excessive hunger, both of which are related to the effects of high blood sugar levels in diabetes. Option D) Tachycardia and diarrhea are more indicative of hyperthyroidism, where the thyroid gland is overactive, leading to symptoms such as rapid heartbeat and increased bowel movements. Educationally, understanding the signs and symptoms of hypothyroidism is crucial for healthcare providers to accurately diagnose and treat patients. By knowing the characteristic features of this condition, appropriate interventions can be implemented to improve patient outcomes. This knowledge also helps in differentiating hypothyroidism from other endocrine disorders with overlapping symptoms, leading to more targeted and effective treatment approaches.