Diabetes insipidus definition

2. DIABETES INSIPIDUS
MS. ANN JOSEPH
M.Sc. Nursing I year

4. Anatomy of pituitary gland

11. TYPES OF DIABETES INSIPIDUS
• CENTRAL (NEUROGENIC) DI
• NEPHROGENIC DI
• PRIMARY DI

12. CENTRAL (NEUROGENIC) DI
 CAUSES:
• Idiopathic
• Infection
• Trauma
• Surgery

13. NEPHROGENIC DI
 CAUSES
• Hereditary
• Amyloidosis
• Polycystic kidney disease
• Hypokalemia

14. PRIMARY DI
 CAUSES
• Defect or damage to thirst mechanism
• Psychological polydipsia
• Iatrogenic polydipsia

16. CLINICAL MANIFESTATION
• POLYURIA:
specific gravity less than 1.050 and
urine osmolality less than 100mOsm/kg

17. • Polydipsia:
May drink up to 4-40 L of fluid.
Craving for cold water .

18. • Dry skin, dry mucous membrane and dry
tongue.

19. • High serum osmolality: above 295mOsm

20. • Nocturia

21. • Fatigue

22. • Anorexia and constipation

23. • High serum sodium level: above 145 mEq/ L

24. • Noctural enuresis

27. DIAGNOSTIC EVALUATION
• Health history
• Physical examination
• Water deprivation test
• Serum sodium level(135-145 mEq/l)
• Urine analysis
• Kidney function test
• Pituitary MRI
• Genetic screening

28. MANAGEMENT
• Vasopressin: 5-10unit/q8-12hr (IM/SC)
• DDAVP: 2-4mcg/day q12hrly
• Thiazide diuretics: 12.5mg/oral
• Chlorpropamide: 250mg/day
• NSAIDS: 40mg/day
• Indomethacin: 25mg TDS
• Dextrose infusion
• Fluid administration (rate of 500- 750ml/hour)

29. Non pharmacological management
• Intake of more fluid orally
• Monitor weight daily
• Ensure easy access of bathroom
• Provide careful skin and mouth care
• Keep skin moisturized

30. SURGICAL MANAGEMENT-
HYPOPHYSECTOMY

31. NURSING MANAGEMENT
• Assess the general condition of the patient.
• Assess for signs of hypovolemia.
• Monitor intake and output hourly.
• Monitor weight daily.
• Monitor skin turgur.
• Assess neurologic status every 2 hourly.
• Ensure safety of patient if he/she is having
dizziness or weakness.
• Encourage to increase fluid intake.
• Provide psychological support.

32. NURSING DIAGNOSIS
• Imbalanced fluid volume related to
hypopituitarism as evidenced by polyuria,
polydipsia
• Disturbed sleeping pattern related to nocturia as
manifested by verbalization of patient about
interrupted sleep.
• Risk for impaired skin integrity related to
urinary frequency.
• Knowledge deficit related to unfamiliarity with
disease as evidence by frequent questioning.

33. COMPLICATION