A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?

Diabetes insipidus is a disorder characterized by insufficient antidiuretic hormone (ADH) activity, leading to excessive production of dilute urine and increased thirst. Clients experience polyuria, dehydration, and hypernatremia due to the inability of the kidneys to concentrate urine. Management focuses on replacing the missing ADH effect and restoring fluid balance. Medication therapy is aimed at reducing urine output and preventing complications related to severe fluid loss. A. Spironolactone is a potassium-sparing diuretic used mainly for conditions such as heart failure, hypertension, and hyperaldosteronism. It promotes sodium and water excretion while conserving potassium, which would worsen polyuria in a client with diabetes insipidus. It does not address the ADH deficiency causing the disorder. B. Desmopressin acetate is a synthetic form of antidiuretic hormone (ADH) and is the primary treatment for central diabetes insipidus. It works by increasing water reabsorption in the renal tubules, thereby decreasing urine output and concentrating the urine. This helps correct dehydration and stabilize serum sodium levels. C. Dopamine is a vasoactive medication used to improve cardiac output, renal perfusion, or blood pressure in critically ill patients depending on the dose. It has no role in replacing ADH or treating the excessive urine output seen in diabetes insipidus. Therefore, it is not the expected. D. Furosemide is a loop diuretic that increases urine production by inhibiting sodium and chloride reabsorption in the kidneys. Since the client already has excessive urine output, administering this medication would worsen dehydration and electrolyte imbalance. It is contraindicated in managing untreated diabetes insipidus.