3. Etiology
Central
Genetic problems
Head injury
Infection
Problem with the ADH-producing cells due to
an autoimmune disease
Loss of blood supply to the pituitary gland
Surgery
Tumors in or near the pituitary gland
4. Nephrogenic involves a defect in the kidneys.
Certain drugs, such as lithium
Genetic problems
High level of calcium in the body
(hypercalcemia)
Kidney disease, such as polycystic kidney
disease
5. Clinical manifestation
a. Polyuria of 4 to 24 L/day
b. Polydipsia
c. Dehydration (decreased skin turgor and dry
mucous membranes)
d. Inability to concentrate urine
e. Low urinary specific gravity, 1.006 or lower
6. f. Fatigue
g. Muscle pain and weakness
h. Headache
i. Postural hypotension that may progress to
vascular collapse without rehydration
j. Tachycardia
7. Diagnostic evaluation
The health care provider will ask about your
medical history and symptoms.
Tests that may be ordered include:
Blood sodium and osmolality
Desmopressin (DDAVP) challenge
MRI of the head
Urinalysis
Urine concentration and osmolality
Urine output
8. Management
a. Monitor vital signs and neurological and
cardiovascular status.
b. Provide a safe environment, particularly for
the client with postural hypotension.
c. Monitor electrolyte values and for signs of
dehydration.
d. Maintain client intake of adequate fluids.
e. Monitor intake and output, weight, serum
osmolality, and specific gravity of urine.
9. f. Instruct the client to avoid foods or liquids
that produce diuresis.
g. Vasopressin tannate (Pitressin) or
desmopressin acetate (DDAVP, Stimate) may be
prescribed; these are used when the ADH
deficiency is severe or chronic.
h. Instruct the client in the administration
ofmedications as prescribed; DDAVP may be
administered by injection, intranasally, or orally.
i. Instruct the client to wear a Medic-Alert
bracelet.
