SIADH vs DI Flashcards
SIADH stands for
syndrome of inappropriate antidiuretic (not diuresing) hormone
inappropriate WATER RETENTION
Releasing of ADH
s/s of SIADH
neuro changes are related to hyponatremia
- headaches, seizures, or coma
- weight gain
- edema
hypothermia
labs/diagnostics of SIADH
hypernatrmic but euvolemic
decreased serum osmolality (<280)
increased urine osmololality (>100)
urine sodium > 20 mEq/L
SIADH treatment
Na > 120- restrict 1L of fluid for 24 hrs
110-120 (no neuro). restrict fluid to 500/ml/ 24 hrs and monitor
if < 110 or neuro symptoms present - REPLACE with isotonic or hypertonic saline and lasix
DI stands for
Diabetes Insipidus
excessive urination and extreme thirst from inadequate output of ADH or lack of response by kidney to ADH
causes of DI
central
- pituitary or hypothalamus damage
- surgical damage
-trauma
- infections
- metastatic cancer
nephrogenic
- damage to renal tubules
- pylonephritis
sickle cell anemia
psychogenic - excessive need to drink water
s/s of DI
- thirst/craving for water
- poluria
- weightloss
- hyperthermia
tachy/hypotension
labs/diagnostics
hypernatremia
serum osmolality > 290
urine osmolality < 300
urine specific gravity- 1.005
normal urine specific gravity
1.010- 1.030
goes in direction of urine osmolality
what test should be used to narroe differential of DI
vasopressin challenge test
how is the vasopressin challenge test conducted
0.05- 0.1 ml nasally or 1 ug SQ OR IV WITH MEASUREMENT OF URINE VOLUME SHOULD BE CONSUCTED.
Test is POSITIVE with Central and NEGATIVE with nephrogenic
management
NA+ > 150 give D5W IV to replace 1/2 volume in 12-24 hrs
Na+ < 150, substitute 1/2 NS or 0.9% NS
DDAVP 1-4 mcg IV or SubQ
On discharge how id DDAVP administered
intranasally
