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SIADH vs DI
WINGO, LYNDSEY C.
Created on August 25, 2023
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Transcript
Syndrome of Inappropriate Antidiuretic Hormone
Diabetes Insipidus
Nursing Care
Diagnostics
What is it?
Signs & Symptoms
Nursing Care
Diagnostics
What is it?
Signs & Symptoms
Next
CAUSES
CAUSES
VS
SIADH
Diabetes Insipidus
- Excessive water conservation
- Increased ADH synthesis, secretion, or BOTH
- Kidneys retain excess water resulting in increased plasma volume = increased blood pressure
- Water intoxication develops
- Deficiency of ADH
- DILUTE urine
- Kidneys don't respond to ADH
- Inadequate water reabsorption
- Body doesn't make ADH
Watch this!
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.
Next
Diagnostics
01
So how do we know our patient has SIADH?
Blood draw to check electrolytes
Blood sample
02
Urine
Urine sample
03
Osmolality
Check osmolality
Next
SIADH Treatment
Next
Nursing Care for SIADH
- Daily weight
- I&O
- Oral care (due to fluid restriction)
- ENFORCE FLUID RESTRICTION!
- Assess neuro status frequently
- Seizure precautions
- Watch for hyponatremia
+ info
+ refresher
Next
Watch this!
Diabetes Insipidus
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
Diagnostics
01
So how do we know our patient has Diabetes Insipidus?
Water deprivation test
Water deprivation test
02
Urine
24 hour urine collection
03
Blood sample
Blood draw to check electrolytes
Next
DI Treatment
Next
Nursing Care for DI
- 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
+ info
+ refresher
What causes SIADH?
- CNS disorders (cerebral edema)
- Drugs: narcotics, chemotherapy
- ADH producing tumor
- Medications: Vasopressin, anesthetics, oral hypoglycemis, tricyclic antidepressants
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.