ADH Disorders

Question 1

balances Na and water in body and controls water conservation

Answer 1

Antidiuretic Hormone

Question 2

ADH is produced in the ? and secreted/stored by the ?

Answer 2

Hypothalamus
Posterior Pituitary Gland

Question 3

The function of ADH is to cause the body to ? and ? blood vessels

Answer 3

Retain water
Constrict

Question 4

Osmolarity: amount of ? in fluid (urine, blood)
Normal Serum Osmolarity: ?

Answer 4

Solute
270-295 mOsm/L

Question 5

Serum Osmo above 295 mOsm/L = water deficit
- Concentration is too ? OR
- Water concentration is too ?

Answer 5

295 mOsm/L
Great
Little

Question 6

Serum Osmo below 270 mOsm/L = water excess
- Amount of particles or solute is ? in proportion to the amount of water OR
- Too ? for the amount of solute

Answer 6

270 mOsm/L
Too Small
Much Water

Question 7

renal tubule permeability to water is increased and water is reabsorbed

Answer 7

Presence of ADH

Question 8

renal tubule permeability to water is decreased – renal excretion to fluids

Answer 8

Absence of ADH

Question 9

Primary regulatory mechanism for the release of ADH

Answer 9

Plasma Osmolality

Question 10

Persistent abnormally high (inappropriate) levels of
ADH in the absence of stimuli with normal renal function

Answer 10

SIADH

Question 11

Feedback system is impaired and posterior pituitary
continues to release ADH

Answer 11

SIADH

Question 12

Renal tubules continue to reabsorb free water regardless of the serum osmolality

Answer 12

SIADH

Question 13

SIADH Causes

Answer 13

Lung problems (Pneumonia/Cancer)
Stroke, Gullian-Barre Syndrome
Damage to Hypothalamus
Drugs - Diabinese

Question 14

SIADH CM: BP, RR

Answer 14

Hypertension
Tachycardia

Question 15

SIADH CM: GI disturbance and Weight?

Answer 15

Anorexia
Gain

Question 16

SIADH CM: Sodium Levels

Answer 16

Euvolemic Hyponatremia

Question 17

SIADH CM: Neuro Status

Answer 17

Confusion (Brain Swelling)
Delirium

Question 18

SIADH CM: Urine Output

Answer 18

Low with concentrated urine output

Question 19

SIADH Management: Monitor?

Answer 19

Weight (Same time each day, Same clothes, Same scale)
I and O
HR and BP

Question 20

SIADH Management: Frequent Neuro Assessment, ? Precautions

Answer 20

Mental Status and LOC
Seizures

Question 21

SIADH Management: ? Restriction

Answer 21

Fluid

Question 22

SIADH Pharmacotherapy: to remove the extra fluids through the kidneys…watch ? levels

Answer 22

Loop Diuretics (Lasix), K+

Question 23

SIADH Pharmacotherapy: to remove fluid from the cell back into the vascular system so it can be urinated out (watch for causing fluid volume overload..give slowly and through central line per hospital protocol)

Answer 23

Hypertonic Solution (3% NSS)

Question 24

SIADH Pharmacotherapy: inhibitor and allow for diuresis…don’t give with ? containing foods like milk or antacids because it affects absorption

Answer 24

Declomycin (Tetracyclin Family)
Calcium

Question 25

Hyposecretion of ADH by the posterior pituitary gland caused by stroke, trauma, or surgery, or it may be idiopathic

Answer 25

Diabetes Insipidus

Question 26

DI Patho: Inadequate secretion of ADH due to loss or malfunction of neurosecretory neurons that make up the posterior pituitary

Answer 26

Central/Neurogenic

Question 27

DI Patho: Vasopressin Sensitive

Answer 27

Central/Neurogenic

Question 28

DI Patho: Inadequate response by the kidneys to ADH. A disorder of renal tubular function resulting in the inability to respond to ADH in absorption of water.

Answer 28

Nephrogenic

Question 29

DI Patho: Vasopressin Resistant

Answer 29

Nephrogenic

Question 30

DI Patho: Suppression of ADH secondary a defect or damage to the thirst mechanism located in the hypothalamus resulting in increased fluid intake or psychogenic causes

Answer 30

Dipsogenic

Question 31

DI CM: Excessive loss of water from body tissue and imbalance of essential electrolytes (Na, K, Cl)

Answer 31

Dehydration

Question 32

DI CM: excessive thirst, excessive amount of urine

Answer 32

Polydipsia, Polyuria 4L-24L per day ( >200 mLs)

Question 33

DI CM: Urine diluted results to ?

Answer 33

Low Specific Gravity (1.001 - 1.005) Serum Hyperosmolality Hypernatremia

Question 34

DI CM: Dry ? & ?, Decrease ?

Answer 34

Mucous membranes, Skin Skin Tugor

Question 35

DI CM: Extreme ? and muscle ?

Answer 35

Fatigue Pain/Weakness

Question 36

DI Management: Strict ?, daily ?, ?, watch other electrolytes ?

Answer 36

I and O Weights Safety Hypokalemia

Question 37

DI Management: Restrict foods that promote ? watermelon, grapes, garlic, berries etc and ? (tea, energy drinks, coffee)

Answer 37

Diuresis Caffeine

Question 38

DI Pharmacotherapy: Mild cases: ? used in type 2 diabetes…not used as much now but it has properties that increases ADH hormone…watch for ? (blood glucose) and educate patient about photo-sensitivity to the ? (mild)

Answer 38

Chlorpropamide (Diabinese) Hypoglycemia Sun

Question 39

DI Pharmacotherapy: Extreme cases: ? (form of vasopressin that naturally occurs in the body which the ADH) also called ? …given PO, IV, nasally, or subq. Side Effects: Watch for the patient to become ? too and ? intoxication

Answer 39

Desmopression Stimate or DDAVP Hyponatremic, Water

Question 40

DI Pharmacotherapy: Maintain client intake of adequate fluids; IV ? may be prescribed to replace urinary losses

Answer 40

Hypotonic Saline