A patient admitted for a head injury develops dry skin and a urine output of 400 ml/hr. Prioritize the nurse's next actions:

1. Notify the physician.

2. Complete a neuro assessment.

3. Assess the patient's urine specific gravity and blood sodium levels.

4. Start IV fluids and administer desmopressin (DDAVP).

2, 1, 3, 4

Explanation

• A urine output of 400 ml/hr after sustaining a head injury may be indicative of diabetes insipidus. Diabetes insipidus is the failure to produce an antidiuretic hormone due to damage to the pituitary gland from increased ICP. With a recent head injury, the nurse should first perform a neuro exam 

• Notifying the physician is appropriate in order for the nurse to obtain orders for additional tests 

• The nurse should then gather information by assessing for low specific gravity and elevated serum osmolarity, as ordered by the physician 

• The physician may order treatments including IV fluids and DDAVP

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