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RN Nursing · Reproductive Hormones and Uterine Motility Medications · Practice question

The nurse is preparing to administer desmopressin to a client diagnosed with diabetes insipidus. Which nursing actions are essential for ensuring safe administration of this medication? (Select all that apply)

Answer & explanation

Correct: Assess serum sodium levels. · Monitor hourly intake and output. · Ensure the medication is administered on time. · Educate the client about signs of hyponatremia.

Desmopressin (DDAVP) is a synthetic antidiuretic hormone analog used to treat diabetes insipidus by promoting water reabsorption in the renal collecting ducts. Safe administration requires several essential nursing actions. Assessing serum sodium levels is critical because desmopressin can cause water retention leading to hyponatremia, a potentially life-threatening complication. Monitoring hourly intake and output allows the nurse to detect fluid retention or inadequate antidiuretic effect promptly. Ensuring the medication is administered on time is important for maintaining consistent control of urine output and preventing recurrence of polyuria. Educating the client about the signs and symptoms of hyponatremia — such as nausea, headache, confusion, and seizures — enables early recognition and reporting of this serious adverse effect. Holding the medication solely because the client reports increased thirst is not appropriate; thirst is a symptom of undertreated diabetes insipidus, meaning the medication may be needed rather than withheld, so clinical assessment should guide the decision. Encouraging aggressive oral fluid intake is contraindicated because additional fluid intake combined with desmopressin's antidiuretic effect greatly increases the risk of severe dilutional hyponatremia and water intoxication. Therefore, the four correct actions collectively address efficacy monitoring, electrolyte safety, adherence, and client safety education.

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