Info

by 30%-70%

Thiazide diuretics

Varies by drug

Decreases polyurea

Effective when the kidney does not respond to vasopressin-like substances

*Note that vasopressin tannate (suspended in oil) is an intramuscular preparation that is given as a 1- to 5-unit injection. The oil-based preparation may have a duration of action as long as 96 hours, whereas the aqueous form lasts from 3 to 6 hours. Desmopressin acetate (DDAVP), a synthetic analog of vasopressin, is given intra-nasally in a dosage of 10 to 25 units twice a day.

*Note that vasopressin tannate (suspended in oil) is an intramuscular preparation that is given as a 1- to 5-unit injection. The oil-based preparation may have a duration of action as long as 96 hours, whereas the aqueous form lasts from 3 to 6 hours. Desmopressin acetate (DDAVP), a synthetic analog of vasopressin, is given intra-nasally in a dosage of 10 to 25 units twice a day.

Independent

The most important nursing interventions focus on maintaining an adequate balance of fluid intake and output. Discuss dietary restriction of salt with the patient and family. The patient should also avoid coffee, tea, or other caffeinated substances since caffeine has exaggerated diuretic effects. The patient needs easy access to the bathroom, bedpan, or urinal. If the patient has muscle weakness or impaired mobility, make sure the pathway for ambulation to the bathroom is free from all obstructions to limit the risk of patient falls.

Monitor the response to all medications and treatments by measuring the urine specific gravity daily as part of assessment data. Normal specific gravity is greater than 1.010. To identify the intake and output balance, monitor and carefully record the oral fluid intake and urine volume over a 24-hour period.

Encourage the patient to wear a medical identification bracelet and to carry any medications at all times. Note that some medications needed for a chronic disease, such as desmopressin acetate (DDAVP), are quite expensive. If the family does not have insurance coverage that includes medications, explore methods to obtain the needed medications. Refer the family to social service if necessary. Urge the patient and family to express their feelings about the patient's condition; if they are having difficulty in coping, arrange for a counseling session.

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