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SIADH vs DI
WINGO, LYNDSEY C.
Created on August 25, 2023
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Transcript
What is it?
Signs & Symptoms
Diagnostics
Nursing Care
What is it?
Signs & Symptoms
Diagnostics
Nursing Care
Syndrome of Inappropriate Antidiuretic Hormone
Diabetes Insipidus
Next
VS
Diabetes Insipidus
- Deficiency of ADH
- DILUTE urine
- Kidneys don't respond to ADH
- Inadequate water reabsorption
- Body doesn't make ADH
CAUSES
CAUSES
SIADH
- Excessive water conservation
- Increased ADH synthesis, secretion, or BOTH
- Kidneys retain excess water resulting in increased plasma volume = increased blood pressure
- Water intoxication develops
Syndrome of Inappropriate Antidiuretic Hormone
Click each of the to review the signs and symptoms of SIADH. Click the button above to watch a video over SIADH and quiz yourself on the treatment.
Watch this!
Next
Next
Diagnostics
Check osmolality
03
Urine sample
02
Blood draw to check electrolytes
01
Urine
Osmolality
Blood sample
So how do we know our patient has SIADH?
SIADH Treatment
Next
Next
+ refresher
+ info
- Daily weight
- I&O
- Oral care (due to fluid restriction)
- ENFORCE FLUID RESTRICTION!
- Assess neuro status frequently
- Seizure precautions
- Watch for hyponatremia
Nursing Care for SIADH
Watch this!
Click each of the to review the signs and symptoms of SIADH. Click the button above to watch a video over SIADH and quiz yourself on the treatment.
Next
Diabetes Insipidus
Next
Diagnostics
Blood draw to check electrolytes
03
24 hour urine collection
02
Water deprivation test
01
Urine
Blood sample
Water deprivation test
So how do we know our patient has Diabetes Insipidus?
DI Treatment
Next
+ refresher
+ info
- Teach patients this can be a CHRONIC condition
- If they are showing signs of LOW ADH - they need to take their meds!
- With meds - be careful of Vasopressin causing fluid overload!
- What does H20 Overload look like?
- Measure I&O
- Encourage fluids
- Daily Weight
- Vital Signs
- Skin/mouth care due to dehydration
- Watch for hypernatremia
Nursing Care for DI
- CNS disorders (cerebral edema)
- Drugs: narcotics, chemotherapy
- ADH producing tumor
- Medications: Vasopressin, anesthetics, oral hypoglycemis, tricyclic antidepressants
What causes SIADH?
SIADH Overview
TOO MUCH ADH! This will cause the body to RETAIN fluid and the urine will be VERY concentrated. Kidneys are using too much ADH
What causes DI?
- Tumors
- Head Injuries
- CVA or Cranial Surgery
- Medications: Lithium, Declomycin
Water Deprivation Test
- Water deprivation test
- Water is withheld for 8-16 hours
- Check BP, weight, osmolality every hour
- The test is stopped when osmolalities stabilities, patient loses 5% of their body weight, or develops orthostatic hypotension
- Once this happens, ADH is given and osmolality is checked in 1 hour
- If there is INCREASED osmolality the patient has Diabetes Insipidus
Diabetes Insipidus Overview
Deficiency of ADH! This will cause the urine to be VERY dilute. Kidneys are not working to respond to ADH so the kidneys are unable to reabsorb the water. This can be due to the body not making or secreting ADH.