Mary Melody M.

Barredo
Competency appraisal
BSN4A

Diabetes insipidus
Diabetes insipidus

Synthesis and storage of antidiuretic hormone

Antidiuretic hormones is produced by the hypothalamus, stored and released by posterior
pituitary gland.
Is an hormones made by the hypothalamus in the brain and act by constantly regulating and
balancing the amount of water in the blood.
Antidiuretic hormone act as the receptors on cells in the kidney in promoting reabsorption of
water back into circulation, with the absence of antidiuretic hormones fluid are released by the
form of urine.
Diabetes insipidus Case study
Case details
A 23 years old male was seen in the emergency department after suffering a concussion head
trauma from motor vehicle accident. The patient was stabilized in the emergency department and
transferred to the intensive care unit or ICU for observation. The patient undergo computed
tomography scan or CT-scan and had revealed a small amount of cerebral edema but was
otherwise normal. During the second day in ICU, the nurse informed that the patient had a large
amount of urine output in the last 24 hours. The nursing records reported that his urine over the
previous 24 hours is measured to be around 5000 cc without given any diuretics. Urine
osmolality is ordered by the doctor and was found to be low.
Case pathophysiology

Diabetes insipidus
Predisposing Precipitating

Cerebral edema
Gender Trauma

Compressed hypothalamus

Posterior pituitary gland Decreased antidiuretic hormone

 Excessive
urination
 Extreme thirst
 Dehydration
 Hypotension
 Hypernatremia

Medical diagnostic Treatment

 Water deprivation test. This test confirms the diagnosis and helps determine the cause
of diabetes insipidus by asking to stop drinking fluids for a time so that your doctor can
measure changes in your body weight, urine output and the concentration of your urine

 Urinalysis. For urine is less concentrated meaning the amount of water is high relative to
other excreted substances due to diabetes insipidus.

 Magnetic resonance imaging (MRI). An MRI of the head is a noninvasive procedure

that uses a powerful magnetic field and radio waves to construct detailed pictures of brain
tissues. Doctor may want to perform an MRI to look for abnormalities in or near the
pituitary gland.

Pharmacologic

 Desmopressin which is an ADH the preferred drug in all patients

 IV fluid
 ADH stimulant carbamazepine
 Nursing responsibilities
 Daily weight
 Strict monitoring of input and output
 Monitor vital signs
 Maintain safety

Assessment Diagnosis Scientific Planning Intervention Rationale Evaluation

Subjective : Fluid volume Excessive After 8 hours of Independent: Independent Goal is met the
N/A deficit related urination and intervention the  Monitor vital  For baseline patient maintained
patient will be signs data the adequate fluid
to excessive extreme thirst able to volume as
Objective : urination as a result of maintained  Monitoring  To monitor evidence by
adequate fluid input and the need for within normal
Urine output of inadequate output fluid
volume as vital signs, moist
5000cc output of the  Daily weight replacement
evidence by : mucus, and
pituitary of patient thru IV verbalizing the
hormone  Within
 Baseline less for wanting
ADH normal Dependent data more water
range of  IV fluid Dependent
vital signs  Desmopressin  Iv fluid for
 Decrease
fluid
urine  carbamazepine replacement
as ordered
output
 Moist
collaborative  ADH
mucus  collaborate stimulant as
with nutrition ordered
 Patient
verbalizing
department  Natural
less of diuresis
food
thirst
prevention