Next, her doctor conducted a carefully monitored water deprivation test. The mor
ID: 87965 • Letter: N
Question
Next, her doctor conducted a carefully monitored water deprivation test. The morning of the test Jamie was weighed at the doctor’s office. Her weight was recorded as 122 lbs. Jamie was to remain at the doctor’s office for the duration of the test. She was put on fluid restriction. A urine and plasma osmolality chart was started. Hourly, the weight of the patient, and her urine and plasma osmolality were measured, and recorded on the chart. Nurses were instructed to terminate fluid restriction if: Patient’s weight fell by > 5% Plasma osmolality increased to > 300 mOsm/kg. If urine osmolality increased by <30 mOsm/kg (in total) over three successive urine samples patient would proceed to DDAVP test DDAVP test should be terminated if urine osmolality rose to >750 mOsm/kg Jamie’s results were as follows: Post Dehydration Osmolality mOsm/Kg Post DDAVP Osmolality mOsm/kg Time Weight Urine osmolality Plasma osmolality Urine Plasma 8:00 122 lbs 200 287 9:00 121.5 lbs 200 290 10:00 120 lbs 200 298 DDAVP administered 11:00 815 290 Post-dehydration osmolality (mOsm/kg) Post DDAVP osmolality (mOsm/kg) Diagnosis plasma urine urine 283-293 > 750 > 750 normal > 293 < 300 < 300 nephrogenic diabetes insipidus > 293 < 300 > 750 cranial diabetes insipidus < 293 300-750 < 750 chronic polydipsia < 293 300-750 < 750 partial nephrogenic DI or primary polydipsia > 293 300-750 > 750 partial cranial DI 7. What is DDAVP? What is the effect on the kidney? Discuss the monitoring of Jamie’s body weight. Why was it important that her weight not be allowed to fall more than 5%? What acute symptoms might she experience if it had?
Explanation / Answer
----> DDAVP is a brand name of a medicine known as Desmopressin that is generally prescribed to treat bed wetting, high blood urea levels, iabetes insipidus or even Von Willebrand disease.
----> it acts by controlling the amounts of urine passage by acting similar to an antidiuretic hormone. This results in a more concentrated urine.
----> the patient was to be put on a fluid deprivation test in which the patient is kept on a restricted fluid intake to check the changes in the weight and urine after restricted fluid intake. In doing so, the body weight of the patient is deliberately allowed to fall to less than 5%, if not so, the test is repeated along with a repeat measurement of blood pressure at an interval of two hours.
----> the patient might experience acute dehydration and extremely concentrated urine, if the weight had fallen for less than 5%.
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