Discussion #1 Diabetes Insipidus Antidiuretic Hormone (ADH) is synthesized in the hypothalamus and secreted by the posterior pituitary. Its role plays part in the body’s osmotic balance, blood pressure regulation, and kidney function. ADH affects the ability of the kidney to reabsorb water and in addition induces expression of water transport proteins in the late distal tubule and collecting duct to increase water reabsorption (Cuzzo & Lappin, 2018). Diabetes Insipidus occurs with a decreased or absent ADH causing symptoms such as polyuria and polydipsia. Three types of diabetes insipidus include: neurogenic, nephrogenic, and polydipsic (McCance & Huether, 2014). Neurogenic DI is the most commen and caused by insufficient amounts of ADH. Damage to the pituitary gland or hypothalamus from surgery, a tumor, a head injury or an illness can cause neurogenic diabetes insipidus by affecting the usual production, storage, and release of ADH (McCance & Huether, 2014). Nephrogenic DI is often idiopathic. It occurs when there's a defect in the kidney tubules. The defect may be due to an inherited disorder or a chronic kidney disorder (McCance & Huether, 2014). Polydipsic DI can cause production of large amounts of diluted urine. The underlying cause is drinking an excessive amount of fluids that is caused by damage to the thirst-regulating mechanism in the hypothalamus. The condition has also been linked to mental illness (McCance & Huether, 2014). “DI must be distinguished from other polyuric states, including diabetes mellitus. The basic criteria for the diagnosis of DI include polyuria, polydipsia, low urine specific gravity (<1.010), low urine osmolality (<200 mOsm/kg), hypernatremia, high serum osmolality (300 mOsm or more depending on adequate water intake), and continued diuresis despite a serum sodium level of 145 mEq/L or greater” (McCance & Huether, p. 720). Treatment for neurogenic diabetes insipidus includes increasing water intake or desmopressin (DDAVP).This medication replaces the missing anti-diuretic hormone and decreases urination. Treatment for nephrogenic diabetes insipidus includes stopping initial cause if medication induced or treatment with thiazide diuretics. Treatment for polydipsic diabetes insipidus includes decreasing fluid intake (McCance & Huether, 2014). A red flag symptom requiring urgent treatment of diabetes insipidus would include passing large amounts of dilute urine. This can cause severe electrolyte disturbances and intravascular depletion leading to shock (McCance & Huether, 2014). Discussion #2 Diabetes insipidus (DI) is a rare condition that occurs when your kidneys are not able to conserve water. DI is not related to diabetes mellitus, which is often referred to simply as diabetes. That means you can have DI without having diabetes. In fact, the condition can occur in anyone. DI results in extreme thirst and frequent urination of dilute and odorless urine. There are several types of DI, and they can often .

1. Discussion #1
Diabetes Insipidus
Antidiuretic Hormone (ADH) is synthesized in the
hypothalamus and secreted by the posterior pituitary. Its role
plays part in the body’s osmotic balance, blood pressure
regulation, and kidney function. ADH affects the ability of the
kidney to reabsorb water and in addition induces expression of
water transport proteins in the late distal tubule and collecting
duct to increase water reabsorption (Cuzzo & Lappin, 2018).
Diabetes Insipidus occurs with a decreased or absent ADH
causing symptoms such as polyuria and polydipsia. Three types
of diabetes insipidus include: neurogenic, nephrogenic, and
polydipsic (McCance & Huether, 2014).
Neurogenic DI is the most commen and caused by insufficient
amounts of ADH. Damage to the pituitary gland or
hypothalamus from surgery, a tumor, a head injury or an illness
can cause neurogenic diabetes insipidus by affecting the usual
production, storage, and release of ADH (McCance & Huether,
2014).
Nephrogenic DI is often idiopathic. It occurs when there's a
defect in the kidney tubules. The defect may be due to an
inherited disorder or a chronic kidney disorder (McCance &
Huether, 2014).
Polydipsic DI can cause production of large amounts of diluted
urine. The underlying cause is drinking an excessive amount of
fluids that is caused by damage to the thirst-regulating
mechanism in the hypothalamus. The condition has also been
linked to mental illness (McCance & Huether, 2014).
“DI must be distinguished from other polyuric states, including
diabetes mellitus. The basic criteria for the diagnosis of DI
include polyuria, polydipsia, low urine specific gravity
(<1.010), low urine osmolality (<200 mOsm/kg), hypernatremia,
high serum osmolality (300 mOsm or more depending on

2. adequate water intake), and continued diuresis despite a serum
sodium level of 145 mEq/L or greater” (McCance & Huether, p.
720).
Treatment for neurogenic diabetes insipidus includes increasing
water intake or desmopressin (DDAVP).This medication
replaces the missing anti-diuretic hormone and decreases
urination. Treatment for nephrogenic diabetes insipidus includes
stopping initial cause if medication induced or treatment with
thiazide diuretics. Treatment for polydipsic diabetes insipidus
includes decreasing fluid intake (McCance & Huether, 2014).
A red flag symptom requiring urgent treatment of diabetes
insipidus would include passing large amounts of dilute urine.
This can cause severe electrolyte disturbances and intravascular
depletion leading to shock (McCance & Huether, 2014).
Discussion #2
Diabetes insipidus (DI) is a rare condition that occurs when
your kidneys are not able to conserve water. DI is not related to
diabetes mellitus, which is often referred to simply as diabetes.
That means you can have DI without having diabetes. In fact,
the condition can occur in anyone.
DI results in extreme thirst and frequent urination of dilute and
odorless urine. There are several types of DI, and they can often
be successfully treated (McCance & Huether, 2014). There are
four types of diabetes insipidus including:
· Central or cranial diabetes insipidus, also called neurogenic
diabetes insipidus
· Nephrogenic diabetes insipidus
· Dipsogenic diabetes insipidus due to malfunction of the thirst
mechanism
Central or cranial diabetes insipidus
This occurs if there is a low level of vasopressin or antidiuretic
hormone (ADH) in the body. The deficiency means the kidneys

3. are not prevented from excreting large amounts of urine and
instead large volumes of dilute urine are expelled, even when
the body has become dehydrated. This also causes blood to lose
water and become more concentrated and higher in salt. This
results in dehydration and stimulation of the thirst center in the
hypothalamus of the brain which causes a person to drink more.
This is the most common type of diabetes insipidus and it is
mainly caused by disease, infection or injury to the pituitary
gland or the hypothalamus gland.
Causes
The causes of cranial diabetes insipidus include:
· Genetic inheritance
The condition may be cause by an inherited mutation in the
vasopressin gene, AVP-NPII which is transmitted to offspring
in an autosomal fashion.
· Acquired disease may have the following causes:
· Tumors of the pituitary gland (pituitary adenoma),
craniopharyngiomas and spread of cancer to the brain (in around
20% of cases). Granuloma formation in the pituitary gland may
be another cause.
· Head injuries (in around 17%)
· Brain surgery (in around 9%)
· Meningitis and encephalitis may cause a small number of
cases
· Sheehan's syndrome and haemochromotosis or deposition of
iron in pituitary/hypothalamic tissue
· Blood vessel complications such as those during pregnancy
where the blood supply to the hypothalamus and the pituitary
gland may be compromised
· Langerhans cell histiocytosis
· About a quarter of cases are idiopathic or without a known
cause
Nephrogenic diabetes insipidus
This condition describes when the ADH level in the body is
normal, but the kidneys do not respond adequately to the
hormone. This may occur due to kidney damage or medications

4. such as lithium reducing the expression of water channels in the
kidneys called aquaporins.
Causes
Nephrogenic diabetes insipidus may be caused by:
· Genetic inheritance
Mutations in the genes that code for ADH receptors may be
inherited and prevent these receptors from activating aquaporins
in the kidneys. Inheritance is autosomal recessive in nature.
· Acquired disease may have the following causes:
· Metabolic disorders such as high blood sugar, high blood
calcium and low potassium
· The use of medications such as demeclocycline or lithium
which reduce aquaporin expression
· Amyloidosis
· Obstructive uropathy
· Chronic kidney disease
· Polycystic kidney disease
Other types of diabetes insipidus
· Dipsogenic diabetes insipidus arises due to malfunction of the
thirst mechanism. Damage to the hypothalamus or pituitary
gland may lead to this condition.
· Gestational diabetes insipidus that occurs pregnancy because
of the placenta producing vasopressinase - an enzyme that
breaks down vasopressin (ADH). This leads to ADH deficiency.
The symptoms usually resolve after childbirth.
Urinalysis
Your doctor will take a sample of your urine to test for salt and
other waste concentrations. If you have DI, your urinalysis will
have a high concentration of water and a low concentration of
other waste.
Water deprivation test
You will be asked to stop drinking water for a specified period
before the test. You will then give blood and urine samples and
your doctor will measure changes in:
· blood sodium and osmolality levels

5. · body weight
· urine output
· urine composition
· ADH blood levels
The test is done under close supervision, and may require
hospitalization in certain people to ensure it’s done safely.
Magnetic resonance imaging (MRI)
This test uses a machine that will take an image of your brain
tissue using magnets and radio waves. Your doctor will then
look at these images to see if there’s any damage to the brain
tissue that is causing your symptoms.
Your doctor will also look closely at images of your
hypothalamus or pituitary gland for any damage or
abnormalities.
Genetic screening
This screening may be performed to look for an inherited form
of DI based on your family history.
The hallmark symptom of diabetes insipidus is an increased
need to urinate. This need can become exceptionally strong,
making the need to use the bathroom immediate. When you do
use the bathroom, you will pass large amounts of urine. The
urine is usually highly diluted, resembling water. The
appearance of clear urine is due to the high amount of water
that it contains. As diabetes insipidus is a result of the
malfunctioning of the body’s ability to regulate water levels,
the water that it is supposed to hold onto is released in the
urine.
Another hallmark symptom that is associated with diabetes
insipidus is an excessive and intense thirst. The desire to drink
can become so severe that it might seem unquenchable, despite
how much water you consume.
Fatigue is a symptom that is commonly associated with several
medication conditions. However, if you feel as if you have no
energy and like all you want to do is sleep, no matter how much
sleep you are getting, and you are also experiencing an
increased need to pass urine and are excessively thirsty, then

6. there is a very good chance that you have developed diabetes
insipidus.
Just like the cells in your body rely on water to perform all its
metabolic functions, your muscles rely on water to stay
hydrated and healthy. If your water levels are not properly
balanced, your muscles are not receiving the vital hydration that
they need to stay healthy.
Diabetes insipidus can also cause patients to feel mentally
confused and unable to concentrate. The reason that mental
confusion can arise because of this condition is directly related
to the lack of water in the body.
Project: Risk Management Plan
Purpose
This project provides an opportunity to apply the competencies
gained in the lessons of this course to develop a risk
management plan for a fictitious organization to replace its
outdated plan.
Learning Objectives and Outcomes
You will gain an overall understanding of risk management, its
importance, and critical processes required when developing a
formal risk management plan for an organization.
Required Source Information and Tools
Web References: Links to Web references in this document and
related materials are subject to change without prior notice.
The following tools and resources that will be needed to
complete this project:
· Course textbook
· Internet access for research
Deliverables
As discussed in this course, risk management is an important
process for all organizations. This is particularly true in

7. information systems, which provides critical support for
organizational missions. The heart of risk management is a
formal risk management plan. The project activities described in
this document allow you to fulfill the role of an employee
participating in the risk management process in a specific
business situation.
The project is structured as follows:
Project Part
Deliverable
Project Part
Risk Management Plan
Submission Requirements
All project submissions should follow this format:
· Format: Microsoft Word or compatible
· Font: Arial, 10-point, double-space
· Citation Style: Your school’s preferred style guide
Scenario
You are an information technology (IT) intern working for
Health Network, Inc. (Health Network), a fictitious health
services organization headquartered in Minneapolis, Minnesota.
Health Network has over 600 employees throughout the
organization and generates $500 million USD in annual
revenue. The company has two additional locations in Portland,
Oregon and Arlington, Virginia, which support a mix of
corporate operations. Each corporate facility is located near a
co-location data center, where production systems are located
and managed by third-party data center hosting vendors.
Company Products
Health Network has three main products: HNetExchange,
HNetPay, and HNetConnect.
HNetExchange is the primary source of revenue for the
company. The service handles secure electronic medical
messages that originate from its customers, such as large
hospitals, which are then routed to receiving customers such as

8. clinics.
HNetPay is a Web portal used by many of the company’s
HNetExchange customers to support the management of secure
payments and billing. The HNetPay Web portal, hosted at
Health Network production sites, accepts various forms of
payments and interacts with credit-card processing
organizations much like a Web commerce shopping cart.
HNetConnect is an online directory that lists doctors, clinics,
and other medical facilities to allow Health Network customers
to find the right type of care at the right locations. It contains
doctors’ personal information, work addresses, medical
certifications, and types of services that the doctors and clinics
offer. Doctors are given credentials and are able to update the
information in their profile. Health Network customers, which
are the hospitals and clinics, connect to all three of the
company’s products using HTTPS connections. Doctors and
potential patients are able to make payments and update their
profiles using Internet-accessible HTTPS Web sites.
NOTE: Any discussion of products not a part of this scenario,
such as health insurance products, will result in an automatic
50% reduction in points. Your paper is not a research paper on
risk management – it is a risk management plan to a very
specific situation and must relate to the scenario, above.
Information Technology Infrastructure Overview
Health Network operates in three production data centers that
provide high availability across the company’s products. The
data centers host about 1,000 production servers, and Health
Network maintains 650 corporate laptops and company-issued
mobile devices for its employees.
Threats Identified
Upon review of the current risk management plan, the following
threats were identified:
· Loss of company data due to hardware being removed from
production systems
· Loss of company information on lost or stolen company-
owned assets, such as mobile devices and laptops

9. · Loss of customers due to production outages caused by various
events, such as natural disasters, change management, unstable
software, and so on
· Internet threats due to company products being accessible on
the Internet
· Insider threats
· Changes in regulatory landscape that may impact operations
Management Request
Senior management at Health Network has determined that the
existing risk management plan for the organization is out of
date and a new risk management plan must be developed.
Because of the importance of risk management to the
organization, senior management is committed to and supportive
of the project to develop a new plan. You have been assigned to
develop this new plan.
Additional threats other than those described previously may be
discovered when re-evaluating the current threat landscape
during the risk assessment phase.
The budget for this project has not been defined due to senior
management’s desire to react to any and all material risks that
are identified within the new plan. Given the company’s annual
revenue, reasonable expectations can be determined.
Project Part 1
Project Part 1 Task 1: Risk Management Plan
For the first part of the assigned project, you must create an
initial draft of the final risk management plan. To do so, you
must:
You Risk Management Plan will contain the following sections:
1. A section titled Introduction discussing the purpose of the
plan. You must include details from the scenario, above,
describing the environment. 10 points.
2. A section titled Scope discussing the scope of the plan. 10
points
3. A section, titled Compliance Laws and Regulations. Using
the information in the scenario provided above, discuss

10. regulations and laws with which Health Network must comply.
30 points
4. A section, titled Roles and Responsibilities, that will discuss
the different individuals and departments who will be
responsible for risk management within the organization (this
was presented in your textbook). 20 points
5. A section, titled Risk Mitigation Plan, that discusses the
threats identified in the scenario and your proposed mitigations,
as well as any new threats.30 points.
Write an initial draft of the risk management plan as detailed in
the instructions above. Your plan should be made using a
standard word processor format compatible with Microsoft
Word.
Evaluation Criteria and Rubrics
· Did the student demonstrate an understanding of the
competencies covered in the course thus far?
· Did the student include all important components of a risk
management plan in the outline?
· Did the student demonstrate good research, reasoning, and
decision-making skills in identifying key components and
compliance laws and regulations?
· Did the student create a professional, well-developed draft
with proper grammar, spelling, and punctuation?
© 2015 by Jones & Bartlett Learning, LLC, an Ascend Learning
Company. All rights reserved.
www.jblearning.com Page 3
Project: Risk Management Plan
© 201
5

11. by Jones & Bartlett Learning, LLC, an Ascend Learning
Company
. All rights reserved.
www.jblearning.com
Page
1
Purpose
This project provides an
opportunity
to apply the competencies gained in
the
lesson
s
of this course to
develop a risk management plan for a
fictitious organization
to replace its outdated plan
.
Learning Objectives and Outcomes
You will
gain an overall understanding of risk management, its
importance, and critical processes
required when developing a formal risk m
anagemen
t p

12. lan for an organization.
Required Source
Information and Tools
Web References:
Links to Web references in this document and related materials
are subject to change
without prior notice.
The following tools and resources
that
will be needed to com
plete this project:
§
Course textbook
§
Internet access for research
Deliverables
As discussed in this course, risk management is an important
process for all organizations. This is
particularly true in information systems, which provides critical
support for
organizational missions. The
heart of risk management is a formal risk management plan.

13. Th
e
project
activit
ies described in this
document
allow you to fulfill the role of an employee participating in the
risk management process in a
specific business situa
tion.
The project is
structured
as follows:
Project Part
Deliverable
Project Part
Risk Management Plan
Submission Requirements
All project submissions should follow this format:
§
Format: Microsoft Word

14. or compatible
§
Font
: Arial, 1
0
-
point
,
d
ouble
-
s
pace
§
Citation Style: Your school’s preferred style guide
Scenario
Project: Risk Management Plan
© 2015 by Jones & Bartlett Learning, LLC, an Ascend Learning
Company. All rights reserved.
www.jblearning.com Page 1
Purpose
This project provides an opportunity to apply the competencies
gained in the lessons of this course to
develop a risk management plan for a fictitious organization to
replace its outdated plan.
Learning Objectives and Outcomes
You will gain an overall understanding of risk management, its
importance, and critical processes

15. required when developing a formal risk management plan for an
organization.
Required Source Information and Tools
Web References: Links to Web references in this document and
related materials are subject to change
without prior notice.
The following tools and resources that will be needed to
complete this project:
Deliverables
As discussed in this course, risk management is an important
process for all organizations. This is
particularly true in information systems, which provides critical
support for organizational missions. The
heart of risk management is a formal risk management plan. The
project activities described in this
document allow you to fulfill the role of an employee
participating in the risk management process in a
specific business situation.
The project is structured as follows:
Project Part Deliverable
Project Part Risk Management Plan
Submission Requirements
All project submissions should follow this format:
-point, double-space
Scenario