Diabetes Insipidus (DI)

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Presentation transcript:

Diabetes Insipidus (DI) www..vipinpatidar.wordpress.com

The disorder of posterior lode of pituitary gland A deficiency of ADH (Vsaopressin) result in inability to conserve Water. Polydipsia Large volume of diluted urine www..vipinpatidar.wordpress.com

DI idiopathic in all about 30% of all clients with DI INCIDENCE DI idiopathic in all about 30% of all clients with DI Tumors can be related to 25% of DI cases Head Injury accounts 16% cranial Surgery for 20% of cases www..vipinpatidar.wordpress.com

Central or neurogenic DI – Etiology Central or neurogenic DI – CNS interruption of anatomic integrity of posterior pituitary Localize Edema Head trauma Central acting drugs or CNS infection www..vipinpatidar.wordpress.com

Rare hereditary disorder Complete DI Occurs when there is disruptions of hypophyseal tract and a complete absence of ADH Neurogenic DI Rare hereditary disorder Acquire structural or functional change in kidney occurs; ADH produce normal but Distal and collecting tubules cannot responds www..vipinpatidar.wordpress.com

Drugs that inhibit vasopressin Release: Risk Factors Head injury Neurosurgery Hypothalamic tumors Pituitary tumor Brain infection Brain Inflammation Drugs that inhibit vasopressin Release: Ethanol, Glucocorticoids, Adrenergic Agents, Lithium www..vipinpatidar.wordpress.com

CLINICAL MANIFESTATIONS Polydipsia Large volume of dilated urine. Integumentary – Dry, cool skin, Dry mucus membrane CV- Tachycardia, hypotension GU- Polyuria- a Few liters to 18L/Day , Clear urine, Urinary frequency Neurologic – Mentation changes as electrolyte imbalance www..vipinpatidar.wordpress.com

Blood test- serum level of ADH Diagnosis finding History Physical examination Blood test- serum level of ADH Urine output- a few liter to 18 liter, Specific gravity decrease, Osmolality <200 MOSm/Kg H2o, 3-5% body weight lost Plasma osmolality increase Serum Na decrease www..vipinpatidar.wordpress.com

ADH Replacement (Desmopresin) MEDICAL MANAGEMENT Iv fluids ADH Replacement (Desmopresin) Clofibrate (hypolipidemic agent, antidiuretic effect Thiazide diuretics, prostaglandin inhibitors Surgical MGT Hypophysectomy to removal of posterior pituitary tumor www..vipinpatidar.wordpress.com

Monitor for excessive thirst or urination Assess serum and urine value Nursing Management Monitor Intake Output Monitor for excessive thirst or urination Assess serum and urine value Client and family teaching www..vipinpatidar.wordpress.com

Complications Electrolyte Imbalance Hypovolemia Hypotension Shock www..vipinpatidar.wordpress.com