diabetes inspidus(1)

8/3/2019 Diabetes Inspidus(1)

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LECTURE : MR. KAMARUL AZIZI SATIMAN

D.M.A (FHLS)

MUHAMMAD ARIFF ADAM LEE

MUHAMMAD HAFIZUDDIN BIN ABU BAKAR

ANDREW BANTA ANAK KURONG


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Definition

Antidiuretic hormone deficiency resulting

damage or tumor occurring in the

posterior lobe of the pituitary gland.


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Classification of D. I

Neurogenic

Nephrogenic

Dipsogenic Gestational


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Diabetes insipidus (DI) causes frequent urination.

The large volume of urineis diluted, mostly water. Tomake up for lost water, you may feel the need to

drink large amounts. You are likely to urinate

frequently, even at night, which can disrupt sleep or,

on occasion, cause bedwetting. Because of theexcretion of abnormally large volumes of dilute

urine, you may quickly become dehydrated if you do

not drink enough water. Children with diabetes

insipidus may be irritable or listless and may havefever, vomiting or diarrhoea. In its clinically

significant forms, diabetes insipidus is a rare

disease


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Sign and Symptoms

Frequent urination (polyuria)

High urine volume

Low urine concentration (pale urine) Severe Thirst

Dehydration

Poor Turgor

Weight Loss Muscle Weakness

Decrease in the urine specific gravity


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Causes

It usually occurs when the kidneys are

unable to conserve water as they

perform their function of filtering blood

It can be caused by damage to the

hypothalamus or pituitary gland as a

result of:

y Head injuryy Infection

y Surgery

y Tumour


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Investigation

Magnetic Resonance Imaging (MRI)

Urinalysis

Urine output

Serum Sodium Increases greater than 145. Full Blood Count (FBC)

Paired Urine & Plasma Osmolalites

Liver function test (LFT)

Bone Profile Fasting Glucose & HbA1c

Base line pituitary function


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Treatment

Administer pitressin (vasopressor)

DDAVP

Provide adequate fluid, avoid fluid with

diuretic effects

Daily weight

Strict I/O chart

Avoid over hydration

Observe daily lab. Value


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Nursing Management

Regular meals, probably 4-5 times daily, andplenty of fluids.

Within 8 hours, patient will maintain adequatefluid volume as evidenced by:

> vital signs is within normal range > urine output of 50- 80ml/hr

> urine specific gravity between 1.004 and1.030

>

moist mucous membranes > good skin turgor

> patient verbalizing that thirst is no longerexcessive


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Nursing Intervention

Monitor Lab. Work & observe for :

Dehydration

Hypernatremia Vital sign changes

Give frequent oral care

Inspect skin


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Evaluation

Patient maintained adequate fluid volume

as evidenced by vital signs, adequate

urinary output with normal specific gravity,

moist mucous membranes, good skinturgor.

patients verbalization that thirst is not

excessive.


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Switch to a low soft diet

Medication like hydrochlorothiazide mayhelp

Take Vital Sign

- Blood pressure- Glucose Test every 4 hours

- Temperature

- Pulse- Respiration spo2


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Complication

Dehydrationy Dry skin

y Dry mucous membrane

y Fever

y Rapid heart ratey Sunken appearance to eyes

y Sunken fontanelles (soft spot) in infants

y Weight loss

Electrolyte imbalancey Fatiguey Headache

y Irritability

y Muscle pain


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THANK YOU. . .

diabetes inspidus(1)

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