A patient recovering from a closed head injury has a urine specific gravity of 1.010 g/mL. The previous intake and output totals were 1,200 mL intake and 10,000 mL output
Which order from the health care provider should the nurse question for this patient?
1. desmopressin (Minirin) 0.2 mg by mouth daily
2. oral fluid restriction of 800 mL per day
3. 3% normal saline at 100 mL per hour
4. computed tomography scan of head
Correct Answer: 1
Desmopressin acetate is administered intranasally or parenterally and is the treatment of choice for SIADH that cannot be treated by correcting the underlying cause. Strategies for correcting the underlying cause of SIADH include treating the hyponatremia with intravenous hypertonic saline, and replacing fluid based on a calculation that adds fluid losses from the prior hour to an hourly base rate of fluid. A CT scan is an appropriate diagnostic tool.
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