ADH Flashcards
SIADH
syndrome of inappropriate ADH
Abnormal production, or sustained secretion of ADH
what is SIADH characterized by?
Fluid retention
Serum hypoosmolality
Hyponatremia
Concentrated urine
What are the causes of SIADH?
malignant – small cell carcinoma of the lung
CNS disorders – head trauma, stroke, tumor
Drug therapy – morphine, SSRI, chemo
Hypothyroidism, infection
pathogenesis of SIADH
Increased ADH
Increased water reabsorption in renal tubules – increases permeability
Increased intravascular fluid volume
Dilutional, hyponatremia and decreased serum osmolality
osmolality of SIADH
Serum osmolality is low, hyponatremia
Urine osmolality in specific gravity is high
Serum sodium is low
urine output is low
t/f weight gain is a part of SIADH
True
s/sx SIADH– hyponatremia
Dyspnea
Fatigue
Neuro – told sensation, confusion, lethargy, muscle twitch, convulsions
s/sx SIADH – G.I.
Impaired taste
Anorexia
Vomiting
Cramps
what occurs with severe hyponatremia?
Irreversible, Neuro damage
What value is considered severe hyponatremia?
<100-115
can a patient die from water intoxication?
Yes, hypotonic medium – swelling in brain
T/F pharmalogic Therapy is the first line of treatment for SIADH
False, directed at underlying cause
diabetes insipidus
Deficiency of ADH, or a decreased Reno response to ADH
what is diabetes insipidus characterized by?
Excessive lots of water in urine
neurogenic DI
Central
cause of neurogenic DI
Hypothalamus/pituitary gland damage
what other disorders are associated with neurogenic DI?
Stroke
Traumatic brain injury
Brain surgery
Cerebral infections
t/f neurogenic DI has a sudden onset
True, usually permanent
where does the nephrogenic DI originate?
Renal origin
cause of nephrogenic DI
Loss of kidney function
Can be drug related
what disorder is associated with nephrogenic DI?
CKD
T/F nephrogenic DI does not have a slow onset
False, progressive
Pathogenesis of DI
decreased ADH
Decreased water reabsorption in renal tubules
Decreased intravascular fluid volume
Increased serum osmolality, excessive urine output
Serum osmolality of DI
high
urine osmolality in specific gravity of DI
Low
serum sodium of DI
High
urine output of DI
High
t/f weight loss is associated with DI
True
s/sx DI
Polyuria, polydipsia
Dehydration
Severe:
Electrolyte imbalance
Hypovolemic shock
DILUTE
Dry
I & O, daily weight
Low specific gravity
Urinate a lot
Treat vasopressin
rEhydrate
