A nurse is caring for a client who has diabetes insipidus. Which of the following medications should the nurse plan to administer?
A.
Lithium
B.
Regular insulin
C.
Furosemide
D.
Desmopressin
The Correct Answer and Explanation is:
The correct answer is:
D. Desmopressin
Explanation:
Diabetes insipidus (DI) is a condition characterized by the inability of the kidneys to conserve water, leading to excessive urination (polyuria) and thirst (polydipsia). There are two types of DI: central DI and nephrogenic DI. In central DI, the problem lies in the inadequate production or secretion of antidiuretic hormone (ADH), also called vasopressin, by the hypothalamus or pituitary gland. Nephrogenic DI involves the kidneys not responding properly to ADH.
Desmopressin, a synthetic analogue of vasopressin, is the treatment of choice for central diabetes insipidus. Desmopressin acts by increasing water reabsorption in the kidneys’ collecting ducts, reducing urine output, and concentrating the urine. This medication mimics the function of naturally occurring ADH and helps restore the balance of fluids in the body. Administering desmopressin can greatly reduce the symptoms of polyuria and polydipsia, preventing dehydration and electrolyte imbalances that are common in untreated DI.
Let’s break down the other options and why they are incorrect:
- A. Lithium: Lithium can actually cause nephrogenic diabetes insipidus by inhibiting the kidney’s response to ADH. It is not used to treat diabetes insipidus and would worsen the condition rather than improve it.
- B. Regular insulin: Insulin is a treatment for diabetes mellitus, not diabetes insipidus. Diabetes mellitus is a completely different condition related to blood sugar regulation, whereas DI is associated with water balance and ADH function.
- C. Furosemide: Furosemide is a loop diuretic used to treat conditions like heart failure and hypertension, as it increases the excretion of water and electrolytes from the body. In diabetes insipidus, where excessive urination is already an issue, furosemide would exacerbate fluid loss and dehydration, making it an inappropriate choice.
In summary, desmopressin is essential in managing central diabetes insipidus by compensating for the lack of ADH, reducing urine volume, and maintaining proper hydration levels.