A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?
- A- “Administer desmopressin while the suspension is cold.”
- B- “Your condition isn’t chronic, so you won’t need to wear a medical identification bracelet.”
- C- “You may not be able to use desmopressin nasally if you have nasal discharge or blockage.”
- D- “You won’t need to monitor your fluid intake and output after you start taking desmopressin.”
Answer C.
- Desmopressin may not be absorbed if the intranasal route is compromised.
- Although diabetes insipidus is treatable, the client should wear medical identification and carry medication at all times to alert medical personnel in an emergency and ensure proper treatment.
- The client must continue to monitor fluid intake and output and receive adequate fluid replacement.
- Diabetes insipidus is caused by an abnormal secretion or action of a secreted hormone in the hypothalamus (DHA). Central diabetes insipidus is distinguished from nephrogenic diabetes insipidus.
- Unlike other type 1 and type 2 diabetes, which causes blood glucose to be too high, diabetes insipidus causes too much urine (several liters per day) and increased thirst. This is a rare form of diabetes.
The answer you selected (choice C) is correct. Here's why:
Desmopressin (DDAVP) is a medication used to treat diabetes insipidus. It works by mimicking the effects of the anti-diuretic hormone (ADH), which helps the kidneys conserve water.
Nasal discharge or blockage can prevent desmopressin from being absorbed effectively if administered intranasally.
Let's analyze the other options and why they are incorrect for client education regarding desmopressin:
- A. "Administer desmopressin while the suspension is cold." There's no evidence that temperature affects the efficacy of desmopressin.
- B. "Your condition isn't chronic, so you won't need to wear a medical identification bracelet." Diabetes insipidus is a chronic condition, and a medical ID bracelet can be crucial in emergencies to alert medical personnel about the client's condition and medication needs.
- D. "You won't need to monitor your fluid intake and output after you start taking desmopressin." Monitoring fluid intake and output remains important to ensure proper hydration and medication effectiveness.
Key points for client education on desmopressin:
- Nasal congestion can affect absorption: Inform the client that a stuffy nose or discharge might affect how well the medication works.
- Continue monitoring fluids: Advise the client to keep track of fluid intake and output even after starting desmopressin.
- Medical ID bracelet: Recommend wearing a medical identification bracelet that mentions diabetes insipidus and the medication used.
