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M.C is a 45-year-old male patient in the Neurology intensive care unit who was admitted 2 days ago after falling from a 10 ft. ladder while working.

M.C is a 45-year-old male patient in the Neurology intensive care unit who was admitted 2 days ago after falling from a 10 ft. ladder while working.

M.C is a 45-year-old male patient in the Neurology intensive care unit who was admitted 2 days ago after falling from a 10 ft. ladder while working. M.C. reportedly hit his head on impact and is being treated for swelling in his brain. The nurse arrives to the unit for her shift and discovers during hand off report that the patient’s output has been 5 liters over the last 24 hours. In addition, the NA+ level has been increasing and is now at 155 mEq/L. The nurse suspects that the patient has developed diabetes insipidus. The patient’s current vital signs are HR 133, BP 90/65, RR 20, Temp 98.9, and O2 Sat 98 on Room Air.

  1. What signs and symptoms are the patient exhibiting that would cause you to consider DI?
  2. What is the pathophysiology of DI?
  3. The nurse prepares to notify the physician regarding the patient’s status; what would you include in your conversation and what recommendations would you make?
  4. The Neurologist then orders a serum osmolarity and a urine osmolarity lab test. What significance would these tests offer for the proper diagnosis?
  5. What is the treatment for this condition? What is priority for the nurse to include in the plan of care and how would you know that the patient is responding appropriately?

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