Week 5 - Diabetes Insipidus Flashcards
recall, what would happen if you had decreased production or secretion of ADH, or lack of renal response to ADH?
inability to conserve water
What are the two types of diabetes insipidus? (2)
- Central (neurogenic)
- interference with ADH synthesis or release - Nephrogenic
- inadequate renal response to ADH
Decreased ADH flow chart
Think: DI = dry inside
What are the clinical manifestations of diabetes insipidus? (7)
- dying of thirst
- polydipsia (excessive thirst)
- abrupt polyuria (kidney not holding onto urine)
- fatigue
- constipation
- weight loss
- dehydration
- decreased LOC, seizures, shock, coma
How is diabetes insipidus diagnosed? (3)
- history and physical exam to possibly determine origin
- labs
- water deprivation test (for your interest only)
What do we look for in a history and physical exam of DI?
- can be caused by brain trauma, brain surgery, so due to damage to the pituitary (central DI) ir by renal issues (not responsive to ADH, called nephrogenic DI)
What lab values do we look at to diagnose DI? (2)
urine osmolality/specific gravity - low
serum osmolality - high (or high-normal if compensating well with oral intake)
How is diabetes insipidus as a whole treated? (2)
- treat primary cause if possible
- goal is to maintain fluid and electrolyte balance
How do we treat central DI? (2)
acute - hypotonic IV saline to replace urine output
DDAVP (desmopressin acetate) - hormone replacement d/t lack of ADH
What should the nurse do to monitor DI? (4)
- input/output
- daily weights
- vital signs
- also assess and client teaching regarding DDAVP administration
What is DDAVP? (2)
- desmopressin acetate
- a synthetic version of ADH
- can be given PO or IV
In general, what is more severe: hypotension or hypertension?
hypotension
