2. Polyuria->excessive urination
•Excessive urination is measured
by volume of urine output, not
frequency of urination. In this
case the abnormal volume is
greater than 2.5L each day.
•Kidneys play an important part
in water homeostasis, so any
condition that impacts their
ability to filter and reabsorb
water impacts urine output
levels.
•Polyuria is a symptom of
numerous disorders so treatment
depends on the underlying cause.
3. Key symptom
Nocturnal polyuria
•Waking up many times at night to
urinate.
•Affects men and women as they age
and suffer from the following
conditions:
• Congestive heart failure-ineffective blood
circulation; edema leading to excessive urine
• Hypoalbuminemia-low albumin levels in blood
resulting in fluid loss from blood and into urine
• Impaired venous flow-edema in extremities
leading to excessive urine.
•Treatment
• Reduced fluid intake
• Increase exercise to remove fluids
• Compression socks
• Elevating legs to limit the buildup of fluids.
• Medication: diuretics, but need to be taken
midday so will not impact sleeping.
4. Causes of polyuria Testing for polyuria
KEY CAUSE: Diabetes insipidus- Blood glucose levels
decreased ADH(antidiuretic
hormone) levels BUN-blood urea nitrogen
Diabetes mellitus-decreased Creatinine blood levels-muscle
sensitivity to ADH.
metabolism waste product
Excessive ingestion of caffeinated
or alcoholic beverages-diuretic Electrolyte concentration-
effect.
Fluid deprivation test-determine
Renal failure-improper filtration of
plasma and reabsorption of fluids. the effect of reducing intake
Polydipsia-extreme feeling of Urinalysis
thirst leads to excess water intake
Osmolality of blood and urine-
e.g. physogenic polydipsia:
antipyschotic medications cause solute concentrations.
polydipsia in patients.
5. Hypercalcemia->condition of excessive calcium in
the blood
•Normally calcium levels in the body are
managed by vitamin D and parathyroid
hormone (PTH).
• Vit. D is found in food such as enriched
dairy or cereals or from sunlight
exposure.
• PTH is produced by the parathyroid
glands.
•Excessive calcium levels, hypercalcemia
can occur because of:
• Primary hyperparathyroidism
• Excessive dietary calcium (especially
because of supplements)
• Limited mobility
• Renal disease
• Cancerous tumors (e.g. breast/lung)
•Kidney stones and neuromuscular
impairment are key indicators.
6. Principal cause-Primary
hyperparathryoidism
•Excessive PTH is secreted by the
parathyroids because of a growth
on the glands.
•Typically associated with women
over 50 years old who also can
have osteoporosis.
•Not preventable but can catch
early with blood calcium testing.
•Treatment may require surgical
removal of PT glands or
medications such as cinacalcet
that limit PTH production. Also
may require medications (e.g.
biphosphonates)to halt or limit
bone loss due to osteoporosis.
7. Symptoms and treatment
•Excessive calcium in blood can present
as mild or severe symptoms and is not
dependent on actual levels:
• Nausea/vomiting
• Polydypsia/polyuria
• Constipation
• Muscle weakness or pain
• Confusion, lethargy, & fatigue
•Complications from elevated calcium
are:
• Osteoporosis b/c calcium is not being stored in
bones or is leaching out.
• Kidney stones form from calcium salts.
• Renal failure
• Neurological impairment that can turn into a
coma.
• Cardiac arrhythmia
•Treatment
• IV fluids
• Hemodialysis
• Biphosphonate-inhibit osteoclasts
• Glucocorticoids-balance the excessive vit. D
levels that accompany hypercalcemia.
