Diabetes Insipidus

  1. General information
    1. Hypofunction of the posterior pituitary gland resulting in deficiency of ADH
    2. Characterized by excessive thirst and urination
    3. Caused by tumor, trauma, inflammation, pituitary surgery
  2. Assessment findings
    1. Polydipsia (excessive thirst) and severe polyuria with low specific gravity
    2. Fatigue, muscle weakness, irritability, weight loss, signs of dehydration
    3. Tachycardia, eventual shock if fluids not replaced
    4. Diagnostic tests
      1. Urine specific gravity less than 1.004
      2. Water deprivation test reveals inability to concentrate urine
  3. Nursing interventions
    1. Maintain fluid and electrolyte balance.
      1. Keep accurate I&O.
      2. Weigh daily.
      3. Administer IV/oral fluids as ordered to replace fluid losses.
    2. Monitor vital signs and observe for signs of dehydration and hypovolemia.
    3. Administer hormone replacement as ordered.
      1. Vasopressin (Pitressin) and vasopressin tannate (Pitressin tannate in oil); given by IM injection
        1. warm to body temperature before giving.
        2. shake tannate suspension to ensure uniform dispersion.
      2. Lypressin (Diapid): nasal spray
    4. Provide client teaching and discharge planning concerning
      1. Lifelong hormone replacement; lypressin as needed to control polyuria and polydipsia
      2. Need to wear Medic-Alert bracelet

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