When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
A. vasopressin (Pitressin Synthetic).
B. furosemide (Lasix).
C. Regular insulin.
D. 10% dextrose.
Correct Answer: A. vasopressin (Pitressin Synthetic).
Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. DDAVP, an ADH analog, can be administered orally, intranasally, subcutaneously, or intravenously. In adults, the dose is ten mcg by nasal insufflation or 4 mcg subcutaneously or intravenously.
Option B: Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences polyuria. Other treatment options for central diabetes insipidus include a low-solute diet (low salt, low protein), thiazide diuretics, chlorpropamide, carbamazepine, and non-steroidal anti-inflammatory drugs (NSAID).
Option C: Insulin is used to treat diabetes mellitus and its complications, not diabetes insipidus. Regular insulin is a medication used in the management of Diabetes Mellitus and hyperglycemia of a variety of etiologies. It is in the short-acting insulin class of drugs. Insulin, regular, which is short-acting human insulin, is a synthetic protein hormone, which, just as the naturally occurring endogenous insulin, exerts a wide range of physiologic effects. Clinical use of insulin is mainly to its ability to lower down serum glucose.
Option D: Clinicians should avoid using crystalloids containing dextrose (D5%W, D10%W, D5% 0.45% NS, etc.) in patients with hyperglycemia. Crystalloid fluids function to expand intravascular volume without disturbing ion concentration or causing significant fluid shifts between intracellular, intravascular, and interstitial spaces.
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