Physiological Integrity Q 29

---

The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:

  

     A. Measure the urinary output

     B. Check the vital signs

     C. Encourage increased fluid intake

     D. Weigh the client

    

    

Correct Answer: B. Check the vital signs

---

A large amount of fluid loss can cause fluid and electrolyte imbalance that should be corrected. The loss of electrolytes would be reflected in the vital signs. Monitor for signs of hypovolemic shock (e.g., tachycardia, tachypnea, hypotension). Frequent assessment can detect changes early for rapid intervention. Polyuria causes decreased circulatory blood volume.

---

Option A: Measuring the urinary output is important, but the stem already says that the client has polyuria. Monitor intake and output. Report urine volume greater than 200 mL for each of 2 consecutive hours or 500 mL in a 2-hour period. With DI, the patient voids large urine volumes independent of the fluid intake. Urine output ranges from 2 to 3 L/day with renal DI to greater than 10 L/day with central DI.

Option C: Encouraging fluid intake will not correct the problem. Allow the patient to drink water at will. Patients with intact thirst mechanisms may maintain fluid balance by drinking huge quantities of water to compensate for the amount they urinate. Patients prefer cold or ice water.

Option D: Weighing the client is not necessary at this time. Monitor serum and urine osmolality. Urine osmolality will be decreased and serum osmolality will increase. Monitor urine-specific gravity. This may be 1.005 or less.

---