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ENDOCRINE COMMON > DI and SIADH > Flashcards

DI and SIADH Flashcards

1
Q

What does Increase ADH means?

A

Water Retention in your body

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2
Q

What happens to the ADH level of patient with Diabetic Insipidus?

A

Decreases!

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3
Q

What are the 4 CM for Diabetes Insipidus?

A
  1. Polydipsia (excessive thirst)
  2. Polyuria (excessive urination)
  3. FVD
  4. Dilute Urine
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4
Q

What is the most common cause of Diabetic Insipidus?

A

Neurogenic
-lack of ADH production

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5
Q

Why is the urine diluted with patients with Diabetic Insipidus?

A

because the kidney cannot “COLLECT” and “CONCENTRATE” urine —> diluted urination

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6
Q

Why do patients with D.I experience Polydipsia?

A

Decrease in ADH means body cannot retain water, so patient PEE a lot. This cause them to be DEHYDRATED

To compensate for the dehydration, they will drink a lot!

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7
Q

What are the 2 complication for D.I?

A
  1. HYPOTENSION
  2. HYPOVOLEMIC SHOCK
    (-because patient is losing fluid in their body)
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8
Q

What are the 2 Treatments that can be used for patient with Diabetic Insipidus?

A
  1. Hormone Therapy (DDAVP)
  2. Intranasal ADH
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9
Q

What does DDAVP do to D.I?

A

DDAVP a.k.a “DESMOPRESSIN” is a synthetic ADH that causes:

  1. increases in water reabsorption
  2. Decrease Urine Output
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10
Q

when do you notify the provider regarding weight status of a patient with D.I?

A

WEIGHT GAIN OF 2LB / 0.9 KG in 24 hours

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11
Q

Why should you restric the fluid intake of patient with D.I?

A

this can lead to water intoxication!

-because they drink too much water

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12
Q

Why should patient with D.I must lower their sodium intake?

A

to help KIDNEY produce LESS URINE

—> Remember, pt with D.I already experience Polyuria

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13
Q

Nursing Education / Responsibilities for patient with D.I?

A
  1. Early detection
  2. MAINTAIN HYDRATION
  3. Hypotonic saline / 5% dextrose
  4. Low Sodium Food
  5. VS, I&O, DAILY WT
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14
Q

Why is HYPOTONIC SOLUTION and 5% Dextrose given to patient with D.I?

A

Hypotonic Solution - treats dehydration

5% Dextrose treats possible Hypernatremia

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15
Q

Dehydration in D.I can lead to what electrolyte imbalance?

A

It can cause Hypernatremia

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16
Q

What can you see in the lab results of patient with D.I?

A
  1. Hypernatremia
  2. High Plasma Osmolality
  3. Low Specific Gravity <1.005
    —> because patient’s urine is DILUTED!
  4. Possible Wate depraviation Test Desmopressin
17
Q

how do you do the ADH STIMULATION TEST a.k.a Water Depraviation Test

A

assessing the patient’s ability to concentrate urine when fluid is witheld

After VASOPRESSIN INJECTION:

1 Urine becomes concentrated = NEUROGENIC DI

  1. No change =
    NEPHROGENIC DI / Psychogenic Polydipsia (compulsive behavior od drinking too much fluid)
18
Q

What 2 things a patient might experience with D.I?

A

Confusion
ATAXIA

19
Q

What happens to the ADH level of patient with SIADH?

A

EXCESSIVE INCREASE!

20
Q

What happens when you have too much ADH?

A

Increase water reabsorption = RETAINING WATER

-Water Intoxication
-Edema
-Hyponatremia
-Low Plasma Osmolality

21
Q

What is the most common cause of SIADH?

A

Hormone Secreting Tumor

(Lung Cancer)

22
Q

What are the CM of SIADH?

A

-Fluid Overload
-Muscle Cramps
-Headache
-Concentrated urine
-Thirst

23
Q

What are the “Early Manifestation of SIADH?

A

-Headache
-Weakness
-Anorexia
-Muscle Cramps
-Weight Gain

24
Q

What are the 4 Complication of SIADH? MCSC

A

-Muscle Twitching
-Confusion
-Seizure
-COMA

25
Q

What are the Lab values for a patient with SIADH?

A

-Hyponatremia
-Low Serum Osmolality
-High Urine Specific Gravity >1.030 (bc urine is CONCENTRATED)

26
Q

What are the possible treatments for SIADH?

A

-Restore Normal Fluid Volume
-FLUID RESTRICTION
-LASIX ( Na >125 mEq/L)

27
Q

How do you provide comfort measure for patient in Fluid restrictions?

A

-Mouth Care
-Ice Chips
-Lozenges
-Staggered Water Intake

28
Q

What kind of solution should be give for patient with SIADH?

A

0.9% Sodium Chloride (ISOTONIC)

29
Q

When the client is experiencing ALTERED MENTAL STATUS, what should you do?

A

DECREASE Environmental Stimuli

30
Q

What are your responsibilities as a nurse?

A

-Seizure Precaution
-Fall Precaution
-HOURLY Neuro Check
-Monitor U/O

-VS, I&O, DAILY WT

31
Q

What should you monitor for a patient with SIADH?

A

Heart Failure

ENDOCRINE COMMON (2 decks)

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