A nurse is preparing to administer an IV osmotic diuretic to a client with increased intracranial pressure (ICP). Which of the following should the nurse identify as the purpose of the medication?
To lower intracranial pressure by increasing urinary output.
To reduce cerebral blood flow.
To prevent the formation of cerebral edema.
To decrease brain oxygen consumption.
The Correct Answer is A
A. The primary purpose of administering an osmotic diuretic, such as mannitol, is to lower ICP by promoting diuresis, which results in increased urinary output and decreases fluid volume in the brain.
B. Osmotic diuretics do not specifically reduce cerebral blood flow; rather, they work by reducing fluid volume and thus intracranial pressure.
C. While osmotic diuretics can help manage edema, their primary role is not solely to prevent the formation of cerebral edema but to actively reduce existing pressure.
D. Osmotic diuretics do not directly decrease brain oxygen consumption; their main function is to create an osmotic gradient that pulls fluid from the brain to reduce ICP.
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Correct Answer is B
Explanation
A. While monitoring serum electrolytes is important, it is secondary to assessing for immediate life-threatening conditions.
B. Monitoring for signs of shock is the priority, as Addisonian crisis can lead to severe hypotension and shock, which requires immediate intervention.
C. Monitoring daily weights can help assess fluid status but is not critical in the context of an impending crisis.
D. Monitoring intake and output is important for overall assessment but does not directly address the immediate risks associated with Addisonian crisis.
Correct Answer is B
Explanation
A. Insufficient insulin production is related to diabetes mellitus, not Cushing's syndrome.
B. Long-term use of glucocorticoids is a well-known exogenous cause of Cushing's syndrome, as it leads to excess cortisol in the body.
C. Adrenal insufficiency refers to a deficiency of adrenal hormones and would not cause Cushing's syndrome, which is characterized by excess hormones.
D. Overproduction of growth hormones is associated with acromegaly or gigantism, not Cushing's syndrome, which primarily involves excess cortisol.