Medical-Surgical Nursing: Diabetes Insipidus

Diabetes insipidus is characterized by:

polyuria, polydipsia

This type of diabetes insipidus results from an interference with ADH synthesis, transport, or release. It is the most common type of DI.

Central (neurogenic) DI

Which of the following signs and symptoms is NOT expected with Diabetes Insipidus? a. Polyuria b. Polydipsia c. Polyphagia d. Extreme thirst

c. Polyphagia Rationale: This s/sx is for DM, not DI.

This type of diabetes insipidus results from excessive water intake. It is not related to ADH, and it occurs when the mechanism that makes a person feel thirsty is damaged. It can be caused by damage to the hypothalamus or by mental illness.

Dipsogenic/primary/psychogenic DI

True or False: Patients with DI may eat foods that promote diuresis such as watermelon, grapes, caffeine, and lemons.

False Rationale: Foods that promote diuresis must be restricted such as watermelon, grapes, caffeine, and lemons because the patient is already excreting large volumes of water through the urine (polyuria).

This rare type of diabetes insipidus happens during pregnancy when an enzyme made by the placenta destroys ADH in the mother.

Gestational DI

In diabetes insipidus, urinary specific gravity is:

Low Rationale: Urine specific gravity is a laboratory test that shows the concentration of all chemical particles in the urine. This is low in DI; whereas in SIADH, urinary specific gravity is high.

This type of diabetes insipidus results from inadequate renal response to ADH despite presence of adequate ADH.

Nephrogenic DI

True or False: Most patients with DI compensate for the fluid loss by drinking large amounts of water. They usually crave water and/or ice.

True Rationale: A patient with DI urinates frequently, and the body compensates by drinking large amounts of water (polydipsia).

True or False: The most common findings in patients with diabetes insipidus are polydipsia, polyuria, and nocturia.

True Rationale: Low ADH -> increased water loss through polyuria. Polydipsia is how the body compensates for the excessive loss of water.

In diabetes insipidus, ADH is _______________. a. Decreased B. Increased

a. Decreased Rationale: ADH is increased in SIADH.

ADH is produced in the _______________, and stored in and secreted by the _____________. a. Hypothalamus; Posterior pituitary gland b. Posterior pituitary gland; Hypothalamus

a. Hypothalamus; Posterior pituitary gland

ADH is also called _____________. a. Vasopressin b. Desmopressin

a. Vasopressin

You are developing a care plan for a patient with DI. Which of the following would be a potential nursing diagnosis for this patient? a. Fluid volume overload b. Fluid volume deficient c. Acute pain d. Impaired skin integrity

b. Fluid volume deficient Rationale: Fluid volume overload is a potential nursing dx for SIADH.

Which of the following is not a cause of DI? a. Damaged hypothalamus/pituitary gland b. Lung cancer c. Pregnancy d. Trauma to the brain

b. Lung cancer

What should be the nursing management for patients with DI? a. Daily weights b. Strict I&O's c. Safety d. All of the above

d. All of the above

Which is the most appropriate diagnostic procedure to diagnose DI? a. CT Scan b. CBC c. Urinalysis d. Water deprivation test

d. Water deprivation test Rationale: This test can help health care professionals diagnose diabetes insipidus and identify its cause.

Which of these is not a medication for DI? a. Diabinese b. Chlorpropramide c. Stimate d. Desmopressin e. Declomycin

e. Declomycin Rationale: Declomycin is an ADH inhibitor that promotes diuresis. This is a medication used for DI's counterpart, SIADH.