Which prescription for a patient with diabetes insipidus would the nurse question
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Diabetes insipidus is a rare condition that occurs when the kidneys are unable to conserve water during the process of filtering blood. This form of diabetes is different than diabetes mellitus or "sugar" diabetes. Both forms of diabetes are associated with excessive urination, but have different causes and treatments. Show
Diabetes insipidus is caused by a lack of antidiuretic hormone (ADH), also called vasopressin, which prevents dehydration, or the kidney's inability to respond to ADH. ADH enables the kidneys to retain water in the body. The hormone is produced in a region of the brain called the hypothalamus. It is stored and released from the pituitary gland, a small gland at the base of the brain. When diabetes insipidus is caused by a lack of ADH, it is called central diabetes insipidus. This form of the disease can be caused by damage to the hypothalamus or pituitary gland. When the condition is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus, which may be inherited. This form of the disease involves a kidney defect that prevents the body from reabsorbing water back into the bloodstream. It is the rarest form of this uncommon disease. Our Approach to Diabetes InsipidusUCSF is an international leader in endocrinology care. Our team provides comprehensive consultations, evaluations and treatments for a wide range of hormone disorders, such as diabetes insipidus. We treat this condition with a medication called desmopressin acetate, or DDAVP. The medication is similar to antidiuretic hormone, the hormone implicated in diabetes insipidus. We will adjust the dosage for each individual to find the right balance between controlling symptoms and avoiding complications. Our goal is to help our patients return to healthy, normal lives. The medication used to treat this disorder is called desmopressin acetate (DDAVP), which is similar to the antidiuretic hormone (ADH), also called vasopressin, produced by your body. DDAVP comes in several forms. Your doctor will work with you to prescribe the one that works best for you. The different forms are:
Don't take the medication if you don't need it. Take your medication when you are:
If you take too much DDAVP or take it when you don't need it, your body may retain too much fluid and you may develop a condition called hyponatremia, which can be life-threatening. Warning signs of this disorder include decreased thirst and urination, headache, nausea, fatigue and confusion. If you feel that your symptoms aren't being controlled or if you experience some of the warning signs of hyponatremia, contact your doctor so your medication dose can be adjusted. If properly treated, you should be able to maintain your normal lifestyle and activities. Diabetes insipidus is a rare condition where you pee a lot and often feel thirsty. Diabetes insipidus is not related to type 1 diabetes or type 2 diabetes (also known as diabetes mellitus), but it does share some of the same signs and symptoms. The 2 main symptoms of diabetes insipidus are:
In very severe cases of diabetes insipidus, a person can pee up to 20 litres of urine in a day. Find out more about the symptoms of diabetes insipidus When to seek medical adviceYou should always see your GP if you're feeling thirsty all the time. Although it may not be diabetes insipidus, it should be investigated. Also see your GP if you're:
Children tend to pee more frequently because they have smaller bladders. But seek medical advice if your child pees more than 10 times a day. Your GP will be able to carry out a number of tests to help determine what's causing the problem. Find out more about diagnosing diabetes insipidus What causes diabetes insipidusDiabetes insipidus is caused by problems with a hormone called vasopressin (AVP), also called antidiuretic hormone (ADH). AVP plays a key role in regulating the amount of fluid in the body. It's produced by specialist nerve cells in a part of the brain known as the hypothalamus. AVP passes from the hypothalamus to the pituitary gland, where it's stored until needed. The pituitary gland releases AVP when the amount of water in the body becomes too low. It helps retain water in the body by reducing the amount of water lost through the kidneys, making the kidneys produce more concentrated urine. In diabetes insipidus, the lack of production of AVP means the kidneys cannot make enough concentrated urine and too much water is passed from the body. In rare cases, the kidneys do not respond to AVP. This causes a specific form of diabetes insipidus called nephrogenic diabetes insipidus. People feel thirsty as the body tries to compensate for the increased loss of water by increasing the amount of water taken in. Find out more about the causes of diabetes insipidus Who's affected by diabetes insipidusDiabetes insipidus affects about 1 in 25,000 people in the general population. Adults are more likely to develop the condition, but it can occur at any age. In rarer cases, diabetes insipidus can develop during pregnancy, known as gestational diabetes insipidus. Types of diabetes insipidusThere are 2 main types of diabetes insipidus:
Cranial diabetes insipidusCranial diabetes insipidus occurs when there's not enough AVP in the body to regulate urine production. Cranial diabetes insipidus is the most common type of diabetes insipidus. It can be caused by damage to the hypothalamus or pituitary gland – for example, after an infection, operation, brain tumour or head injury. In about 1 in 3 cases of cranial diabetes insipidus there's no obvious reason why the hypothalamus stops making enough AVP. Nephrogenic diabetes insipidusNephrogenic diabetes insipidus occurs when there's enough AVP in the body but the kidneys fail to respond to it. It can be caused by kidney damage or, in some cases, inherited as a problem on its own. Some medications, particularly lithium (used to help stabilise mood in some people with specific mental health conditions, such as bipolar disorder), can cause nephrogenic diabetes insipidus. Treating diabetes insipidusTreatment is not always needed for mild cases of cranial diabetes insipidus. You just need to increase the amount of water you drink to compensate for the fluid lost through urination. If necessary, a medication called desmopressin can be used to replicate the functions of AVP. Nephrogenic diabetes insipidus is often treated with medications called thiazide diuretics, which reduce the amount of urine the kidneys produce. Find out more about treating diabetes insipidus ComplicationsAs diabetes insipidus increases water loss in the urine, the amount of water in the body can become low. This is known as dehydration. Rehydration with water can be used to treat mild dehydration. Severe dehydration will need to be treated in hospital. Find out more about the complications of diabetes insipidus Page last reviewed: 13 October 2022 Which is a key assessment finding in a patient suspected of having diabetes insipidus?The most common findings in patients with diabetes insipidus are polydipsia, polyuria, and nocturia. Polyuria is defined as a urine output of more than 3 L/day in adults or 2 L/m2 in children.
Which assessment finding is expected in a patient diagnosed with Cushing's disease?A patient suspected of having Cushing's syndrome must initially have an appearance suggestive of excess cortisol production combined with an elevated 24-hour urinary excretion of cortisol.
Which hormone does the nurse State has both inhibiting and releasing action?In nursing women, prolactin is released in response to suckling by the infant. Several releasing and inhibitory factors from the hypothalamus also control prolactin release. The most important of those factors is dopamine, which has an inhibitory effect.
Which signs and symptoms would the nurse expect to find in a patient with Addison's disease?Symptoms of Addison's disease include:. Steadily worsening fatigue (most common symptom).. Patches of dark skin (hyperpigmentation), especially around scars and skin creases and on your gums.. Abdominal pain.. Nausea and vomiting.. Diarrhea.. Loss of appetite and unintentional weight loss.. |
