SIADH vs DIABETES INSIPIDIS

Question 1

Hormone involved

Answer 1

Antidiuretic Hormone (post pit gland) (vasopressin)

Question 2

excessive release of ADH

Answer 2

SIADH - ADH levels

Question 3

deficiency in ADH

Answer 3

DI - ADH levels

Question 4

inability of kidneys to conserve water

Answer 4

DI - effect on kidneys

Question 5

drug induced, tumors, head injuries

Answer 5

both - common causes

Question 6

Caused by respiratory disorders and meningitis

Answer 6

SIADH - other causes

Question 7

nephrogenic (congenital most common; but also PKD or hypercalcemia)

Answer 7

DI - causes

Question 8

Can be caused by phenytoin, NSAIDs and alcohol

Answer 8

SIADH - meds that can cause

Question 9

Concentrated serum chemistry
Hypernatremia / HYPOkalemia
Increased serum osmolality

Answer 9

DI - effect on blood serum

Question 10

Polyuria and polydipsia
urine o/p >50 mL/kg/day
may crave ice water

Answer 10

DI - effects on third and urine freq

Question 11

dehydration, weight loss, and dry skin

Answer 11

DI - fluid volume effects

Question 12

Diagnostic Med and Tx: Vasopressin

Answer 12

DI, if DI administration will improve urine and serum chemistries

Question 13

teaching: avoid foods with diuretic action

Answer 13

DI - diet

Question 14

Teaching: lifetime vasopressin replacement therapy

Answer 14

DI - med teaching

Question 15

If DI is nephrogenic in origin, what med will be prescribed?

Answer 15

Thiazide diuretics - they stimulate ADH production and retain sodium - what origin?

Question 16

Concentrated Urine
Increased urine sodium >30 mEq/L
Urine osmolality >200 mOsm/kg

Answer 16

SIADH -

effects on urine

Question 17

HYPOnatremia

decreased serum osmolality

Answer 17

SIADH -

effects of blood serum

Question 18

confusion, irritability

Answer 18

SIADH -

neuro affects

Question 19

increased vasopressin levels

Answer 19

SIADH -

effect on vasopressin levels

Question 20

weight gain

Answer 20

SIADH - effects on weight

Question 21

weakness, anorexia, nausea, vomiting

Answer 21

SIADH - general affects

Question 22

Edema plus hyponatremia

Answer 22

Clinical caution!!
SIADH is generally not the culprit!!
Notify provider promptly if both of these are noted

Question 23

Nursing: restrict fluids

Answer 23

SIADH - teaching fluids

Question 24

Nursing - Weight client daily, monitor I&O very closely (fluids = output +500)
monitor mental status frequently
seizure precautions

Answer 24

SIADH -

daily/hourly nursing interventions

Question 25

Med: Sodium infusions

Answer 25

SIADH -

IV fluids used if sodium is profoundly low

Question 26

Med: Loop Diuretics

Answer 26

SIADH -

meds if hypervolemic and hyponatremic

Question 27

Vasopressin Receptor Antagonist:
Conivaptin (Vaprisol)
Tolvaptan (Samsca)

Answer 27

SIADH -

Meds if serum sodium is less than 125 mEq)