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
