ADH Disorders (Exam 3) Flashcards
(32 cards)
ADH is the major regulator of what?
Water supply in the body
Sodium makes up ______ of the body’s osmolality
80%
If our blood is hypernatremic then our cells will
Shrink
If blood is hyponatremic than our cells will
Swell
ADH: How it works
Increase Plasma Osmolarity or Decrease Circulation Volume
()
Increase thirst and Increase ADH Secretion
()
Increase fluid intake and decrease water excretion
()
Increase Water Retention
()
Increase Circulating Volume
()
Decrease ADH + Decrease Thirst
ADH (Vasopressin) Problems
Syndrome of Inappropriate ADH
(too much)
Diabetes Insipidus (too little)
SIADH
Overproduction of ADH
Results in excess water reabsorption and decrease serum sodium levels (diluted)
Cells swell as fluid shifts into intracellular spaces
What is the most common cause of SIADH
Ectopic Hormone production from lung cancer cells
Paraneoplastic Disorders
Sometimes the signs and symptoms of SIADH can lead us to find
Lung Cancer
Diabetes Insipidus
Underproduction of ADH
Diabetes Insipidus Causes
Neurogenic
-head trauma
-posterior pituitary not secreting ADH
Nephrogenic
-Lithium
-Kidney does not respond to ADH in blood
Signs and Symptoms of DI
Polydipsia (both DI and DM)
Polyurea (both DI and DM)
NO POLYPHAGIA IN DI
SIADH: Patho Map (KNOW ARROWS)
Increase ADH
Increase water reabsorption in renal tubules
Increase intravascular fluid volume
Dilutional hyponatremia and decrease serum osmolality
SIADH: Clinical Manifestation
Depends on severity and rate of hyponatremia
-Muscle cramping
-Dyspnea
-Fatigue
-Neurologic: Dulled sensorium, confusion, lethargy
-GI: Impaired taste and anorexia
Severe Hyponatremia
<100-115 mEq/L
SIADH: Priority Nursing Probelms
Excess fluid volume
Risk for injury r/t confusion
SAIDH: Excess Fluid Volume Nursing Interventions
-Assess S/S volume overload
-Monitor I&O
-Monitor changes in mental status
-Restrict fluid per order
-Administer pharm per order
-Administer IVF per order
-Family/patient support
Immediate Goal of SIADH patient
Restore normal fluid volume and osmolarity
SIADH: How to treat mild symptoms and mild hyponatremia (<125)
-Fluid restriction only (1000ml/day)
SIADH: How to treat severe symptoms or severe hyponatremia (<115)
-3-5% NS IV SLOWLY over hours to days
-500 ml/day fluid restriction
Chronic SIADH drug therapy
-Diuretics
-Demeclocycline (block ADH)
DI: Patho Map
Decrease ADH
()
Decreased water reabsorption in renal tubules
()
Decreased intravascular fluid volume
()
Increased serum osmolality (hypernatremia) + Excessive urine output
DI: Clinical Manifestations
Polyuria (5-20 LITERS/Day)
+
Polydipsia
Urine: Low specific gravity and Low osmolality
Serum: High osmolality (300 mOsm or greater)
-results of hypernatremia due to pure water loss in kidney
-high osmolality makes them want to drink, drink, drink
Fatigued from nocturia and weakness
Normal Serum Osmolality
270-290
