DI and SIADH Questions
6. Vasopressin should be used with caution in patients with _________and _______.
heart failure, kidney disease
7. A client with a pituitary tumor is being prepared for a transsphenoidal hypophysectomy. Which preoperative instruction should receive the highest priority when formulating the teaching plan? A. Teaching coughing and deep breathing techniques B. Reviewing the signs and symptoms of infection C. Alerting the client to the need for constant monitoring following surgery D. Warning the client to avoid coughing and sneezing after surgery
D. Warning the client to avoid coughing and sneezing after surgery
9. Which of the following would be a major focus of planning care for the client after transsphenoidal hypophysectomy? Monitoring for a. Cerebrospinal fluid leak b. Fluctuating blood glucose levels c. Cushing's Syndrome d. Respiratory complications
a. Cerebrospinal fluid leak
3. A client who suffered a brain injury after falling from a ladder has recently developed syndrome of inappropriate antidiuretic hormone (SIADH). What findings indicate that the treatment he is receiving for SIADH is effective? (More than one answer). a. Decrease in body weight b. Rise in blood pressure and drop in heart rate c. Absence of wheezes in the lungs d. Increase in urine output e. Decrease in urine osmolarity
a. Decrease in body weight d. Increase in urine output e. Decrease in urine osmolarity
2. The nurse is performing an admission assessment on a client who has been diagnosed with diabetes insipidus. Which of the following findings should the nurse expect to note during the assessment? (More than one answer) a. Extreme polyuria b. Excessive thirst c. Elevated systolic blood pressure d. Low urine specific gravity e. Bradycardia f. Elevated serum potassium level
a. Extreme polyuria b. Excessive thirst d. Low urine specific gravity f. Elevated serum potassium level
14. A priority outcome criterion for the client with Diabetes Insipidus would include which of the following a. Maintains normal fluid balance b. Selects American Diabetes Association diet correctly c. States dietary restrictions d. Exhibits serum glucose level within normal range
a. Maintains normal fluid balance
15. Nursing care planning for a client recovering from transsphenoidal hypophysectomy would include which of the following a. Rinsing the mouth with saline solution b. Performing frequent tooth brushing c. Cleaning the teeth with an electric toothbrush d. Rinsing the mouth with peroxide
a. Rinsing the mouth with saline solution
1. The client has a tumor of the posterior pituitary gland. The nurse planning his care should include which of the following interventions? (More than one answer) a. Take daily weights b. Restrict fluids c. Assess urine specific gravity d. Encourage intake of coffee or tea e. Monitor intake and output
a. Take daily weights c. Assess urine specific gravity e. Monitor intake and output
12. Diabetes Insipidus is a possible complication after pituitary surgery. For which symptom should the nurse observe to aid detection of Diabetes Insipidus? a. Urine specific gravity less than 1.005 b. Urine output between 1 and 2 liters per day c. Blood glucose level above 300 mg/1000 ml d. Urine negative for glucose and ketones
a. Urine specific gravity less than 1.005
17. A 62 year old female is admitted with a posterior pituitary tumor and is experiencing diabetes insipidus, a complication of that tumor. The nursing diagnosis most appropriate for this client is a. Fluid volume excess b. Deficient fluid volume c. Bowel incontinence d. Diarrhea
b. Deficient fluid volume
13. Vasopressin is administered to the client with Diabetes Insipidus because it acts to a. Decrease tubular reabsorption of water b. Increase tubular reabsorption of water c. Increase release of insulin from the pancreas d. A decrease glucose production within the liver
b. Increase tubular reabsorption of water
10. Before undergoing a transsphenoidal hypophysectomy for pituitary adenoma, the client asks the nurse how the surgeon closes the incision made in the dura. The nurse would respond based on the knowledge that a. Dissolvable sutures are used to close the dura b. The nasal packing provides pressure until normal wound haling occurs c. A patch is made with a piece of fascia d. A synthetic mesh is placed to facilitate healing
c. A patch is made with a piece of fascia
8. To help minimize the risk of postoperative respiratory complications, the nurse would focus the clients preoperative teaching on the importance of a. Using blow bottles b. Making frequent position changes c. Deep breathing d. Coughing
c. Deep breathing
11. Initial treatment for a cerebrospinal fluid leak after a transphenoidal hypophysectomy for pituitary tumor would most likely involve a. Repacking the nose b. Returning the client to surgery c. Enforcing bedrest with the head of the bed elevated d. Out of bed ambulating ad lib
c. Enforcing bedrest with the head of the bed elevated
16. The nurse teaches the client to monitor for signs and symptoms of which potential complication after hypophysectomy? a. Acromegaly b. Cushing's disease c. Diabetes Mellitus d. Hypopituitarism
d. Hypopituitarism
4. Hypothalmic diabetes insipidus is a syndrome characterized by _________ and __________.
dilute urine, increased thirst