SOPHIA KAYE M.

AGUINALDO

ACTIVITY 1

Considering what you have learned at this point, what diagnostic tests are relevant for SIADH
secretion and DI?

Answer:

For SIADH secretion, to a complete medical history and physical examination, your

child's doctor will order blood tests to measure sodium, potassium chloride levels and
osmolality (concentration of solution in the blood). These tests are necessary to confirm
a diagnosis of SIADH. While in DI, the indirect water deprivation test is the most well tested and
widely utilized as the standard diagnostic test for DI. Adjunctive measurements of plasma AVP
or copeptin levels can enrich the diagnostic yield of the water deprivation test.

SOPHIA KAYE M. AGUINALDO

ACTIVITY 2

Based on what you have learned so far, describe SIADH secretion briefly as to causes, clinical
manifestations, and medical and nursing management.

Answer:

SIADH tends to occur in people with heart failure or people with a diseased

hypothalamus (the part of the brain that works directly with the pituitary gland to produce
hormones). In other cases, a certain cancer (elsewhere in the body) may produce the
antidiuretic hormone, especially certain lung cancers. Clinical manifestation includes cramps or
tremors, depressed mood, memory impairment, irritability, personality changes, such as
combativeness, confusion, and hallucinations. Therapeutic modalities include nonspecific
measures and means (fluid restriction, hypertonic saline, urea, demeclocycline), with fluid
restriction and hypertonic saline commonly used. Recently vasopressin receptor antagonists,
called vaptans, have been introduced as specific and direct therapy of SIADH. Restrict fluid as
ordered, generally <500 mL/day in severe cases and 800 to 1000 mL/day in moderate cases.
Administer potassium supplements as ordered, assess renal function and ensure adequate
urine output before administering potassium.
SOPHIA KAYE M. AGUINALDO

ACTIVITY 3

Based on what you have learned at this point, describe DI briefly as to causes, clinical
manifestations, and medical and nursing management.

Answer:

Diabetes insipidus is caused by problems with a chemical called vasopressin (AVP),

which is also known as antidiuretic hormone (ADH). AVP is produced by the hypothalamus and
stored in the pituitary gland until needed. The hypothalamus is an area of the brain that
controls mood and appetite. The symptoms of diabetes insipidus include extreme thirst that
can't be quenched (polydipsia), excessive amounts of urine (polyuria) and colourless urine
instead of pale yellow. Typically, this form is treated with a man-made hormone called
desmopressin (DDAVP, Minirin, others). This medication replaces the missing anti-diuretic
hormone (ADH) and decreases urination. You can take desmopressin as a nasal spray, as oral
tablets or by injection. Nursing management includes monitoring of intake and output, weight,
and specific gravity of urine, maintaining the intake of adequate fluids, and monitoring for signs
of dehydration. Instruct also the client to avoid foods or liquids that produce diuresis,
administer chlorpropamide (Diabinese) if prescribed for mild diabetes insipidus.