Diabetes Insipidus
- Diabetes Insipidus (DI) NOT ENOUGH ADH. Nothing is stopping you from peeing away all your water. You become DRY INSIDE.
- 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.
/*! elementor – v3.12.1 – 02-04-2023 */
.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=”.svg”]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block} 
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.
/*! elementor – v3.12.1 – 02-04-2023 */
.elementor-accordion{text-align:left}.elementor-accordion .elementor-accordion-item{border:1px solid #d5d8dc}.elementor-accordion .elementor-accordion-item+.elementor-accordion-item{border-top:none}.elementor-accordion .elementor-tab-title{margin:0;padding:15px 20px;font-weight:700;line-height:1;cursor:pointer;outline:none}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{display:inline-block;width:1.5em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon svg{width:1em;height:1em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-right{float:right;text-align:right}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-left{float:left;text-align:left}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-closed{display:block}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-opened,.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-closed{display:none}.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-opened{display:block}.elementor-accordion .elementor-tab-content{display:none;padding:15px 20px;border-top:1px solid #d5d8dc}@media (max-width:767px){.elementor-accordion .elementor-tab-title{padding:12px 15px}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{width:1.2em}.elementor-accordion .elementor-tab-content{padding:7px 15px}}.e-con-inner>.elementor-widget-accordion,.e-con>.elementor-widget-accordion{width:var(–container-widget-width);–flex-grow:var(–container-widget-flex-grow)}
Causes of DI
Head trauma, irradiation of pituitary gland, CNS infections (TB, meningitis)
- Large amount of diluted urine (polyuria)
- Polydipsia
- Dehydration
- Dry mouth
- Hypotension
- Hypernatremia
- Muscle weakness
- Orthostatic hypotension
- Urine with low specific gravity (very dilute) <1.010
- Can go into hypovolemic shock
- D dehydration
- Urine Diluted
- Polydipsia
- Polyuria
- Experiencing bedwetting and muscle weakness
- Dry Mouth
- 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
- The opposite is true of SIADH.
Very low specific gravity since patient makes lots of diluted urine (specific gravity < 1.010)
- Hypernatremia
- Losing lots of fluid through urine so serum sodium is concentrated
- Hydration
- Hypotonic saline
- ADH (Vasopressin/Desmopressin)
- Monitor weight
- Monitor I & O
The clearer the urine, the lowest the specific gravity. DI’s urine has Low specific gravity <1.010 (Normal 1.010-1.030)
Darker urine has high specific gravity. SIADH retains all the water and pees concentrated with Specific gravity > 1.030
DI makes urine with low osmolality and since it is dry inside, serum osmolality is high
SIADH makes urine with high osmolality (concentrated) and since it is soaked inside, serum osmolality is low.