Unit 5 & 6 Chapter 57 Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Flashcards
What is Diabetes Insipidus (DI)
DRY INSIDE
FLUID VOLUME DEFICIT
Polyuria
Polydypsia
Diabetes insipidus (DI) is a disorder of the posterior pituitary gland in which water loss is caused by either an antidiuretic hormone (ADH) deficiency or an inability of the kidneys to respond to ADH.
What is the cause of secondary
Secondary DI
-caused by diseases that affect the posterior pituitary
Traumatic head injury, neurosurgery,
neoplasms.
Tumors in brain
craniotomy
Urine specific gravity range
1.005-1.030
Your urine specific gravity is generally considered normal in the ranges of 1.005 to 1.030. If you drink a lot of water, 1.001 may be normal. If you avoid drinking fluids, levels higher than 1.030 may be normal.
Primary DI vs Secondary DI
Primary DI–defect in hypothalamus or pituitary gland resulting in dec. ADH production or release
-ANYTHING IN TH BRAIN
Secondary DI-caused by diseases that affect the posterior pituitary
Traumatic head injury, neurosurgery,
neoplasms.
pituaty tumor
S/S of Diabetes Insipidus
Hypotension**
**Tachycardia
Weak peripheral pulses**
* Hemoconcentration
* **Increased urine output(polyuria)**
* **, low specific gravity**
* **Poor turgor**
* **Dry mucous membranes**
* Decreased cognition a
* Ataxia
**Increased thirst (polydyspsia)
* Irritability a
Assessment questions for patient with DI
Ask about a history of recent surgery, head trauma, or drug use (e.g., lithium).
LITHIUM CAN CAUSE DIABTES INSIPIDUS
What medication would you suspect the Health Care Provider to prescribe for a patient diagnosed with Diabetes Insipidus?
A. Furesomide
B. Levothyroxine
C. Epinephrine
D. Desmopressin
D. Desmopressin
This drug, a synthetic form of vasopressin, replaces antidiuretic hormone (ADH) and decreases urination. It is available orally, as a sublingual “melt,” or intranasally in a metered spray.
Nursing Intervention for Diabetes Insipidus
-increase fluid intake
-Administer Desmopressin
- Monitor fluid volume status
- checking urine specific gravity,
- records of daily weight
Does a patient with DI require lifelong drug therapy of Desmopressin?
A. yes
B. no
The patient with permanent DI requires lifelong drug therapy. Check his or her ability to assess symptoms, and adjust dosages as prescribed for changes in conditions. Teach that polyuria and polydipsia indicate the need for another dose.
Complications of Desmopressin
Drug therapy for DI induces water retention and can cause fluid overload
- Weight gain
-Edema
-Crackles in lungs
-Hypertention
Patient teaching Desmopressin
Teach patients to weigh themselves daily to identify weight gain.
Stress the importance of using the same scale and weighing at the same time of day while wearing a similar amount and type of clothing.
If weight gain of more than 2.2 lb (1 kg) along with other signs of water toxicity occurs (e.g., persistent headache, acute confusion, nausea, vomiting), instruct him or her to go immediately to the emergency department or call 911.
Instruct the patient to wear a medical alert bracelet identifying the disorder and drug.
Which urine characteristics indicate to the nurse that the client being managed for diabetes insipidus is responding appropriately to interventions?
A. Urine output volume increased; urine specific gravity increased
B. Urine output volume increased; urine specific gravity decreased
C. Urine output volume decreased; urine specific gravity increased
D. Urine output volume decreased; urine specific gravity decreased
C. Urine output volume decreased; urine specific gravity increased
What is Syndrome of Inappropriate ADH (SIADH)
SWIM INSIDE
FLUID OVERLOAD
OLIGURIA
The syndrome of inappropriate antidiuretic hormone (SIADH) or Schwar -Bar er syndrome is a problem in which antidiuretic hormone (ADH, vasopressin) is secreted even when plasma osmolarity is low or normal, resulting in water retention and fluid overload.
Should you monitor for hyponatremia for patients with SIADH?
A. Yes
B. No
A. Yes
S/s of SIADH
-hyponatremia)
-appetite, nausea, and vomiting,
-weight gain
-lethargy,
-headaches,
-hostility,
-edema
-hypertention
-disorientation,
-change in level of consciousness
-seizures
-coma.
-full and bounding pulse
-Increased urine specific gravity(1.030^)