A 28-year-old woman arrives at the clinic complaining of generalized weakness and frequent, large-volume urination. She has not experienced dysuria, hematuria, or abdominal pain. The patient's symptoms have been present for several months, but she cannot recall when they first appeared. She has no other medical issues. The patient is a single mother with a 2-year-old child who has little social support and uses alcohol and marijuana on occasion "to cope with stress." The vital signs and physical exam are normal. The blood glucose level is 95 mg/dL, and the serum sodium level is 132 mEq/L. A urine analysis reveals no white or red blood cells. Urine osmolality is serially measured during further evaluation while fluid intake is restricted; vasopressin is then administered 7 hours into the test. The outcomes are shown below. Which of the following is the most appropriate long-term treatment for this patient?

Question

A 28-year-old woman arrives at the clinic complaining of generalized weakness and frequent, large-volume urination. She has not experienced dysuria, hematuria, or abdominal pain. The patient's symptoms have been present for several months, but she cannot recall when they first appeared. She has no other medical issues. The patient is a single mother with a 2-year-old child who has little social support and uses alcohol and marijuana on occasion "to cope with stress." The vital signs and physical exam are normal. The blood glucose level is 95 mg/dL, and the serum sodium level is 132 mEq/L. A urine analysis reveals no white or red blood cells. Urine osmolality is serially measured during further evaluation while fluid intake is restricted; vasopressin is then administered 7 hours into the test. The outcomes are shown below.  Which of the following is the most appropriate long-term treatment for this patient?

Quizplus · Accepted Answer

Eductional Objective: Primary (psychogenic) polydipsia is defined by an excessive intake of free water, which causes hyponatremia and the production of large amounts of dilute urine. Water restriction lowers serum sodium levels while raising urine osmolality.

A 28-Year-Old Woman Arrives at the Clinic Complaining of Generalized