Question

The nurse is caring for a 27-year-old patient with a diagnosis of head trauma. The nurse notes that the patient's urine output has increased tremendously over the past 18 hours. The nurse suspects that the patient may be developing:

a. diabetes insipidus.
b. diabetic ketoacidosis.
c. hyperosmolar hyperglycemic syndrome.
d. syndrome of inappropriate secretion of antidiuretic hormone.

Answer 1

The patient with increased urine output following head trauma may be developing diabetes insipidus, which is due to a deficiency in ADH leading to excessive urination (polyuria) and thirst.

Step-by-step explanation:

The nurse caring for a 27-year-old patient with head trauma, who is experiencing a tremendous increase in urine output, may suspect the development of diabetes insipidus. Diabetes insipidus is characterized by chronic underproduction of antidiuretic hormone (ADH) or a mutation in the ADH receptor, leading to an inability of the kidneys to retain water and resulting in excessive urination, known as polyuria. This condition is accompanied by increased thirst, as the body continually loses water through urine, making it necessary for the patient to drink large amounts to attempt to compensate for the loss, though effective water retention is impaired without sufficient ADH. Unlike conditions such as diabetic ketoacidosis or the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), where glucose levels or ADH levels respectively are typically dysregulated, diabetes insipidus involves a lack of ADH or responsiveness to it, which leads to the inability to concentrate urine and conserve water.