Pathophysiology
What is the most common cause of SIADH? What are other causes associated with this process?
(What is....?) 1. Small cell lung cancer 2. Head injury/trauma, stroke, CNS disorders, and brain tumors
Which type of shock is a patient at risk for in DI?
(What is....?) 1. Hypovolemic shock
in DI, the serum osmolality will be low or high?
(What is....?) 1. High
What medication is prescribed for DI?
(What is...?) 1. Desmopressin DDAVP
What can be used to distract patients from thirst in SIADH?
(What is...?) 1. Hard candies, peppermints, or gum
In Diabetes Insipidus, there is a deficiency in which hormone?
(What is...?) Antidiuretic hormone
Which of the following signs and symptoms is NOT expected with Diabetes Insipidus?
A. Polyuria
B. Polydipsia
C. Polyphagia
D. Extreme thirst
(What is...?) C. Polyphagia
What drug do you anticipate a patient will be started on with SIADH?
(What is...?) 1. Declomycin
What medication is used to promote the excretion of sodium in SIADH?
(What is...?) 1. Lasix
What labs need to be monitored closely in SIADH?
(What is...?) 1. Serum sodium levels
There are three types of Diabetes Insipidus, which form is more common?
(what is....?) 1. Central DI is the most common form.
Others include Nephrogenic DI & Primary DI
If a patient's intake does not match the output with DI, this manifestation can lead to what complications?
(What is....?) 1. Dehydration 2. Weight loss, constipation, poor skin turgor, hypotension, tachycardia and shock may occur
The antidiuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH.
(What is...?) 1. Low, High
What kind of IV solution do you want to use in DI?
(What is...?) 1. Hypotonic saline of D5W
If serum sodium levels are below 120, what precautions does the patient need?
(What is...?) 1. Seizure precautions
While providing discharge instructions for the client diagnosed with diabetes insipidus, which priority education point will the registered nurse (RN) stress?
(What is...?) 1. Monitor patient for early signs of dehydration
Name three causes of hyponatremia related to SIADH.
(What is....?) 1. Muscle pain, cramping, weakness
Others include:
2. Thirst, dyspnea on exertion, and fatigue
3. Low UO and Increased body weight
For both DI and SIADH, you will be monitoring what four important things?
(What is...?) 1. Serum osmolality
2. Serum sodium
3. Urine specific gravity
4. Urine osmolality
How is DDAVP administered?
(What is...?) 1. Oral, IV, sub Q, or Nasal spray
What do patients need done daily in DI?
(What is...?) 1. Daily weights
A client is receiving desmopressin acetate for diabetes insipidus (DI). Which actions should the nurse take when caring for this client? Select all that apply.
1. The medication can be stopped as soon as you feel better
2. Monitor intake and output
3. Monitor neurologic and cardiovascular status
4. Monitor serum electrolytes
5. Monitor for Hypotension
(What is...?) 2. Monitor intake and output
3. Monitor neurologic and cardiovascular status
4. Monitor serum electrolytes
5. Monitor for Hypotension
You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient?
A. Fluid volume overload
B. Fluid volume deficit
C. Acute Pain
D. Skin integrity
(What is...?) A. Fluid volume overload
In SIADH, the urine osmolality will be what?
(What is...?) 1. High, the urine will be concentrated
What test confirms the diagnosis of central DI?
(What is...?) 1. Water restriction test
What kind of diet should a patient with DI be taught?
(What is...?) 1. Low sodium diet