diabetes insipidus

diabetes insipidus – disorder of the posterior lobe of the pituitary gland

main problem: deficiency of antidiuretic hormone or vasopressin

related to: (1) secondary to head trauma (2) brain tumor (3) surgical ablation (4) irradiation of the pituitary gland (5) infection of the CNS (6) failure of the renal tubules to respond to ADH

outstanding symptoms: 3Ps – polyuria, polydipsia, polyphagia AND large volume of dilute urine

signs and symptoms: (1) craves cold water (2) patient tend to drink 2 to 20liters daily (3) hypernatremia (4) severe dehydration (5) weight loss

diagnostic test: fluid deprivation test – plasma and urine osmolality study done before and at the end of the test

how? – fluid intake is withheld for 8 to 12 hours or until 3% to 5% of the body weight is lost

(+) diabetes insipidus – failure to increase specific gravity and osmolality of urine

stop! - if patient experiences tachycardia, hypotension and excessive weight loss

nursing management:

(1) admin medicines as ordered: (a) desmopressin – intranasal administration (b) lypressin – intranasal administration (c) vasopressin tannate in oil – intramascular administration (d) Clofibrate & Chlorpropamide

(2) administer vasopressin with caution if patient with coronary artery disease – has vasoconstrictive action