Chapter 16, Problem 2CCS

70-Year-Old Male with Polyuria

Mr. Gutteman, a 70-year-old male, was brought into the ER. He had been sick several days with the flu, and was found confused and barely conscious by his daughter.

Mr. Gutteman is breathing rapidly and has a fever of 39°C (102°F). His skin is dry and flaccid, his mucous membranes are dry, and his eyes are sunken. The physician ordered:

•IV (intravenous) fluid and electrolyte replacement

•Blood and urine tests for presence of glucose and ketones

•Strict I&O [careful measurement of fluid intake (e.g., IV, drinking) and output (e.g., urine)]

2. NCLEX-STYLE Given this new information, Mr. Gutteman's excessive fluid loss in his urine most likely indicates:

a. An increased blood level of aldosterone

b. A decreased blood level of antidiuretic hormone

c. An increased blood level of antidiuretic hormone

d. A decreased blood level of insulin