DIABETES INSIPIDUS

Question 1

what is diabetes insipidus?

Answer 1

deficiency of ADH that reduces the ability of the distal tubes in kidneys to collect and concentrate urine–> peeing too much

Question 2

what are types of diabetes insipidus?

Answer 2

1. primary: the most common with an early onset and usually a genetic deficit
2. secondary: later onset, usually physical deficit due to brain surgery or head injury
3. nephrogenic: ADH production is normal but kidneys do not respond to it
4. drug induced: lithium or demeclocycline

Question 3

what are clinical manifestations of diabetes insipidus?

Answer 3

1. excessive urine output of very dilute urine (30L)
2. electrolyte imbalances
3. dehydration that causes thirst
4. hypotension–>shock
5. dry mucuous membranes (due to dehydration)
6. weak, poor peripheral pulses

Question 4

what are lab findings for a patient with diabetes insipidus?

Answer 4

1. increased serum osmolarity levels, increased BUN and CRT, increased electrolytes, and increased hematocrit
2. decreased urine specific gravity that will be < 1.005

Question 5

what are the priority interventions for a patient with diabetes insipidus?

Answer 5

1. dehydration is the priority so give these patients fluids
2. strict I&Os and monitor vitals and daily weights
3. restrict diuretics like caffeine
4. promote safety by having side rails up, helping patient with ambulation, and having easy access to bedpan or bathroom

Question 6

what medication can help treat diabetes insipidus and what are some teaching points on it?

Answer 6

desmopressin is a synthetic ADH medication that is effective when USG is high. be cautious when giving with CAD patients due to vasoconstriction. this is a lifelong medication for patients to be on