Diabetes Insipidus
- Diabetes Insipidus (DI) NOT ENOUGH ADH. Nothing is stopping you from peeing away all your water. You become DRY INSIDE.Â
- May happen after a hypophysectomy (pituitary removal), which is done via the transsphenoidal approach. The client will have a nasal packing. DO NOT REMOVE THE NASAL PACKING or the “mustache dressing” under the nose, even if it is bloody. These dressings are only changed with a doctor’s order.Â
DO NOT REMOVE THE NASAL PACKING or the “mustache dressing” under the nose, even if it is bloody. These dressings are only changed with a doctor’s order.
Causes
- Head Trauma
- Irradiation of pituitary gland
- CNS infections (TB, meningitis)
- Brain Surgery
Signs and Symptoms
Polyuria
Lots of urine due to ↓ ADH
Dehydration
Due to large urine output
Hypernatremia
Due to water loss and sodium concentration
Hypotension
Due to volume loss
Polydipsia
Due to high sodium and water loss
Dry Mouth
Due to fluid loss
- The clearer the urine, the lowest the specific gravity. DI’s urine has low specific gravity < 1.010.
- Darker urine has high specific gravity. SIADH retains all the water and pees concentrated with Specific gravity > 1.030
- Osmolality in simple terms is how concentrated something is.
- In DI, urine is dilute so very low osmolality (diluted)
- Client is dehydrated so serum has high osmolality (concentrated) > 295 mOsm/kg
- Normal Osmolality = 275 to 295 mOsm/kh
- The opposite is true of SIADH.
| Diabetes Insipidus | SIADH | |
|---|---|---|
| Amount of Urine | A lot | A little |
| Urine Specific Gravity | Low (<1.010) | High (> 1.030) |
| Urine Osmolality | Low (Dilute urine) | High (Concentrated urine) |
| Serum Osmolality | High (Concentrated from dehydration) | Low (Dilution from fluid retention) |
| Serum Sodium | High (Concentrated from dehydration) | Low (Dilution from fluid retention) |
| Urine Color | Clear | Dark |
