SIADH, DI, Acromegaly SP
After providing education for a patient with acromegaly who is beginning bromocriptine therapy, the nurse identifies that which statement by the patient indicates the need for further teaching?
" the medication should help my lips return to normal size"
The nurse expects to find which intervention in a plan of care for a patient with diabetes insipidus?
- Assess mucous membranes - perform strict urinary intake and output
The nurse instructs a patient who takes bromocriptine to treat acromegaly that which side effect requires immediate medical attention?
- Dizziness - Chest pain - watery nasal discharge
Which finding indicates the possibility of SIADH?
- Full bounding pulse - Elevated urine sodium levels - decreased serum sodium level
Which is a key assessment finding in a patient suspected of having diabetes insipidus?
- Tachycardia - increased thirst - dry mucous membranes
Which manifestation does the nurse expect in a patient with SIADH?
- Water retention - full bounding pulse - decreased sodium serum level
The nurse expects which assessment finding in a patient who presents to the emergency department with symptoms consistent with a diagnosis of nephrogenic diabetes insipidus?
- hypotension - low vasopressin level
Which intervention is appropriate for a patient with a pituitary tumor who has developed SIADH?
- restrict fluid intake - assess liver function - administer tolvaptan
When a patient with SIADH reports a 3.3 lb increase in weight in one day, the nurse calculates which amount of fluid retention in the patient?
1500ml
Which prescribed intervention does the nurse perform first when caring for a patient with SIADH whose serum sodium level is 105
Administer infusion of 150 ml of 3% sodium chloride over 3 hours
To prevent increased intracranial pressure after a hypophysectomy, the nurse instructs the patient to take which precaution?
Consume high fiber foods and drink plenty of fluids
The nurse monitors for which indication of fluid overload in a patient with SIADH who is receiving IV hypertonic saline?
Crackles in the lungs
Which intervention does the nurse provide when a patient with diabetes insipidus experiences dry lips, mucus membranes and poor skin turgor?
Encourage fluids
The nurse expects which intervention on a postoperative plan of care for a patient who has undergone a hypophysectomy?
Have the patient avoid brushing the teeth for 2 weeks after surgery
After providing a patient with discharge education about drug therapy and treatment for diabetes insipidus, the nurse identifies that which statement by the patient indicates effective teaching?
I will need to weigh myself every day
The nurse expects which assessment finding in a patient with SIADH?
Increase urinary osmolarity
The nurse identifies that which finding in a patient who is 4 hours post hypophysectomy should be reported to which health care provider immediately?
Increased swelling
Which symptom is associated with vasopressin hormone deficiency?
Increased thirst
To avoid increasing intracranial pressure, which intervention does the nurse implement for a patient who has undergone a hypophysectomy?
Instruct the patient not to strain during bowel movements
During the immediate postoperative period, which instruction does the nurse provide to a patient who underwent a hypophysectomy?
Keep the head of the bed elevated
When performing an assessment one day after a patient underwent a hypophysectomy, the nurse identifies that which finding has an immediate implication for the patient's care?
Patient reports headache and stiff neck
Which teaching does the nurse provide to a patient who has undergone nasal hypophysectomy
Report any postnasal drip after surgery
Which condition results from excessive secretion of vasopressin even when plasma osmolarity is low or normal?
Schwartz-bartter syndorme
The nurse provides information to a patient about which condition that may occur when taking desmopressin nasal spray to treat diabetes insipidus?
Sensation of chest tightness
Which finding in a patient with SIADH is a priority to report to the health care provider?
Serum Sodium of 115 mEq/L
Which serum laboratory finding is most important to monitor in a patient diagnosed with diabetes insipidus?
Sodium
When assessing a patient's elimination pattern, the nurse identifies that which finding needs further evaluation to rule out the possibility of diabetes insipidus ?
The patient reports excessive thirst and increased frequency of urination
What is a common feature of acromegaly?
Thickened lips
Which medication teaching does the nurse provide for a patient who is prescribed nasal spray desmopressin for diabetes insipidus?
Ulceration of the mucous membranes may occur with intranasal use
Which assessment finding in a patient with diabetes insipidus being treated with drug therapy is a priority for the nurse to report to the health care provider?
Weight gain of 2.4 lbs in one day
The nurse expects a prescription for which medication for a patient with diabetes insipidus secondary to lithium overdose?
desmopressin
The nurse expects that which medication will be prescribed for a patient whose assessment findings include increased thirst, porr skin turgor, tachycardia, and urine output in 24 hours that is 4.5 L greater than the volume of fluid ingested?
desmopressin
Which laboratory result indicates that fluid restrictions have been effective in treating SIADH?
increased serum sodium
Which is the cause of nephrogenic diabetic insipidus
lack of response of the kidney tubules to the actions of antidiuretic hormone
Which information about eh GI tube care in patient with SIADH does the nurse include in education given to nursing students?
use saline instead of water to give drugs through the tube
The nurse questions which prescription that is listed on the plan of care for a patient with hyperpituitarism ?
vasopressin