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. Weight gain is not a symptom of hyperthyroidism; in fact, patients often experience weight loss.
B. Beta blockers are commonly used to manage symptoms of tachycardia and palpitations associated with hyperthyroidism, as they help to decrease heart rate and reduce anxiety.
C. Weight loss is a typical symptom of hyperthyroidism, and beta blockers do not address this issue directly.
D. Depression is not a primary indication for beta blocker use in hyperthyroidism; instead, they are more focused on managing the cardiovascular symptoms associated with the condition.
Correct Answer is C
Explanation
A. The supine position can increase ICP and is not recommended for clients with elevated ICP.
B. Instructing the client to pull themselves up may increase ICP due to straining.
C. Log rolling helps maintain spinal alignment and minimizes abrupt head movement, which is essential in managing ICP.
D. Sitting with legs dangling may cause a sudden shift in intracranial pressure and is not advised for these clients.