A client with long-term nephrogenic diabetes insipidus (DI) is admitted to a medical unit. During the medication reconciliation process, the nurse realizes it is crucial that which medication be included in the client's regimen?
1. Chlorpropamide
2. Hydrochlorothiazide (HCTZ)
3. Intranasal or oral desmopressin
4. Conivaptan (Vaprisol)
Correct Answer: 2
Rationale 1: This medication is not indicated for long-term nephrogenic diabetes insipidus.
Rationale 2: Nephrogenic DI is a condition in which the kidneys do not respond to ADH or conserve water properly. The conventional treatment is administration of the thiazide diuretic HCTZ.
Rationale 3: Additional desmopressin (ADH) will not help treat the disorder.
Rationale 4: Conivaptan (Vaprisol) would make the problem worse because it is a vasopressin-receptor blocker.
Global Rationale: Nephrogenic DI is a condition in which the kidneys do not respond to ADH or conserve water properly. The conventional treatment is administration of the thiazide diuretic HCTZ. ADH supplementation is not effective. Conivaptan (Vaprisol) would make the problem worse because it is a vasopressin-receptor blocker.
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