The Christ College of Nursing and Health Sciences
NUR 305 – Review
Case Study One
Ed is a 17-year-old football player who experienced a head injury while playing football. Ed was
diagnosed with traumatic brain injury (TBI) and is currently undergoing TBI rehabilitation.
1. What signs and symptoms would alert the nurse to the possible post-trauma complication of
diabetes insipidus (DI)?
Answer: Hypotension, decreased pulse pressure, weak peripheral pulses, polyuria, polydipsia, and
nocturia, as well as decreased skin turgor and cracked or dry mucous membranes.
Rationale: Water loss is a concern for patients who develop DI; signs and symptoms will mirror those
found in patients who are dehydrated.
2. What laboratory findings are consistent with DI?
Answer: Increased hemoglobin and hematocrit; increased BUN; excessive urine output (> 4 L and
greater than the amount of intake); diluted urine; low specific gravity (< 1.005), hypo-osmolarity (50 to
200 mOsm/kg).
Rationale: Laboratory manifestations will be consistent with dehydration.
The primary care provider has prescribed desmopressin, 10 mcg nasally every 8-12 hours.
3. What teaching points should the nurse provide to Ed regarding nasal inhalation of desmopressin?
Answer: The nurse should teach the importance of blowing the nose before taking the medication
nasally, sitting upright before administration, and holding the breath while spraying into the nostril. In
addition, the nurse should teach the patient to inform the primary care provider abnormal adverse
effects of the drug. The patient can also be informed to discuss the medication with the pharmacist.
Rationale: Nasal administration of desmopression indicates that the drug will be absorbed through the
nasal mucosa. Blowing the nose prior to administration decreases the amount of nasal secretions that
could interfere with absorption; sitting upright and holding the breath keeps the drug in contact with the
nasal mucosa, as opposed to allowing it to run down the throat, which in turn increases absorption.
Informing the primary care provider can help the patient optimal results of treatments. Discussing the
medication with the pharmacist may help the patient understand the medication and increase
compliance.
Give med on time watch for s/s of fluid overload (too much ADH)
Case Study Two
Rau Kuohui, a 50-year-old female, was shot in the right side of her chest. She is currently in the
progressive care unit. Her arterial blood gases are as follows:
pH 7.30
PaO2 88 mmHg
PaCO2 50 mmHg
Bicarbonate 26 mEq/L
Lactate 5 mg/dL
This study source was downloaded by 100000842568006 from CourseHero.com on 05-30-2022 17:25:49 GMT -05:00
https://www.coursehero.com/file/46778306/acid-base-hormonal-glucose-review-FACULTYdocx/
NUR 305 – Review
Case Study One
Ed is a 17-year-old football player who experienced a head injury while playing football. Ed was
diagnosed with traumatic brain injury (TBI) and is currently undergoing TBI rehabilitation.
1. What signs and symptoms would alert the nurse to the possible post-trauma complication of
diabetes insipidus (DI)?
Answer: Hypotension, decreased pulse pressure, weak peripheral pulses, polyuria, polydipsia, and
nocturia, as well as decreased skin turgor and cracked or dry mucous membranes.
Rationale: Water loss is a concern for patients who develop DI; signs and symptoms will mirror those
found in patients who are dehydrated.
2. What laboratory findings are consistent with DI?
Answer: Increased hemoglobin and hematocrit; increased BUN; excessive urine output (> 4 L and
greater than the amount of intake); diluted urine; low specific gravity (< 1.005), hypo-osmolarity (50 to
200 mOsm/kg).
Rationale: Laboratory manifestations will be consistent with dehydration.
The primary care provider has prescribed desmopressin, 10 mcg nasally every 8-12 hours.
3. What teaching points should the nurse provide to Ed regarding nasal inhalation of desmopressin?
Answer: The nurse should teach the importance of blowing the nose before taking the medication
nasally, sitting upright before administration, and holding the breath while spraying into the nostril. In
addition, the nurse should teach the patient to inform the primary care provider abnormal adverse
effects of the drug. The patient can also be informed to discuss the medication with the pharmacist.
Rationale: Nasal administration of desmopression indicates that the drug will be absorbed through the
nasal mucosa. Blowing the nose prior to administration decreases the amount of nasal secretions that
could interfere with absorption; sitting upright and holding the breath keeps the drug in contact with the
nasal mucosa, as opposed to allowing it to run down the throat, which in turn increases absorption.
Informing the primary care provider can help the patient optimal results of treatments. Discussing the
medication with the pharmacist may help the patient understand the medication and increase
compliance.
Give med on time watch for s/s of fluid overload (too much ADH)
Case Study Two
Rau Kuohui, a 50-year-old female, was shot in the right side of her chest. She is currently in the
progressive care unit. Her arterial blood gases are as follows:
pH 7.30
PaO2 88 mmHg
PaCO2 50 mmHg
Bicarbonate 26 mEq/L
Lactate 5 mg/dL
This study source was downloaded by 100000842568006 from CourseHero.com on 05-30-2022 17:25:49 GMT -05:00
https://www.coursehero.com/file/46778306/acid-base-hormonal-glucose-review-FACULTYdocx/
