A nurse is caring for a client with a urine specific gravity of less than 1.005, polyuria, and nocturia. The nurse recognizes that which of the following physiologic findings is the likely cause?
Increased insulin production
Increased adrenocorticotropic hormone (ACTH)
Low levels of T3, T4
Insufficient antidiuretic hormone (ADH)
The Correct Answer is D
A. Increased insulin production would not cause polyuria and low specific gravity urine; rather, hyperglycemia from lack of insulin can cause high specific gravity due to glucose in urine.
B. Increased ACTH affects cortisol production but is not directly related to urine concentration or polyuria.
C. Low T3 and T4 levels are associated with hypothyroidism, which typically does not cause polyuria or decreased specific gravity.
D. Insufficient ADH, as seen in diabetes insipidus, leads to the inability to concentrate urine, resulting in a low specific gravity, polyuria, and nocturia due to excessive water loss.
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Correct Answer is B
Explanation
A. While reporting dizziness is important, it does not directly aid in managing vertigo episodes.
B. Instructing the client to get up slowly while turning their entire body helps to reduce vertigo symptoms by minimizing head movement, which can trigger or worsen dizziness in Meniere’s disease.
C. Driving is not recommended during symptomatic periods of vertigo, as it could be unsafe.
D. The logroll technique is typically used for clients with spinal issues rather than vertigo management in Meniere’s disease.
Correct Answer is D
Explanation
A. Monitoring glucose levels may be necessary, as pheochromocytoma can cause hyperglycemia, but it is not the immediate priority.
B. A CT scan may be part of the diagnostic process to locate the adrenal tumor, but the priority is to control blood pressure first due to the risk of severe hypertensive crisis.
C. Serum calcium levels are not directly related to pheochromocytoma and are not a priority action.
D. Monitoring blood pressure is critical, as pheochromocytoma causes episodes of severe hypertension, which can lead to life-threatening complications.