Question

Following a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, the nurse suspects the development of:

1) Hypovolemic shock
2) Diabetes insipidus
3) Acute renal failure
4) Urinary tract infection

Answer 1

The nurse suspects the development of Diabetes insipidus.Thus option 2 is the correct answer.

Step-by-step explanation:

Following a closed head injury in a 10-year-old child, the manifestation of copious amounts of pale urine and a drop in blood pressure strongly suggests the development of diabetes insipidus (DI). DI is a condition characterized by inadequate antidiuretic hormone (ADH) production or response, leading to the excretion of large volumes of dilute urine. In this case, the closed head injury may have affected the hypothalamus or pituitary gland, disrupting the normal release of ADH. The resulting polyuria (increased urine output) can lead to hypovolemia, explaining the drop in blood pressure.

Diabetes insipidus can be differentiated from other conditions based on its characteristic features. Unlike hypovolemic shock, which involves a loss of intravascular volume, DI specifically involves impaired water reabsorption in the kidneys. Acute renal failure is associated with decreased kidney function, leading to the retention of waste products and electrolyte imbalances, rather than excessive urine production. While urinary tract infections can cause changes in urine color, they are unlikely to result in copious pale urine and a drop in blood pressure.

In summary, the presentation of copious pale urine and decreased blood pressure in the unconscious child after a closed head injury strongly points to the development of diabetes insipidus, indicating a disruption in the normal regulation of fluid balance and antidiuretic hormone secretion.The nurse suspects the development of Diabetes insipidus.Thus option 2 is the correct answer.