THE NCLEX CHANNEL

{ Diabetes Insipidus (DI) vs.

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) }

Session Objectives:

Objective 1: Review expected assessment findings of DI and SIADH.

Objective 2: Discuss diagnosis of DI and SIADH.
Objective 3: Explore nursing management for clients diagnosed with DI and
SIADH.

Points of Emphasis:
Diabetes insipidus (DI) and the syndrome of inappropriate antidiuretic hormone
(SIADH) are both endocrine disorders caused by abnormal production or release
of antidiuretic hormone (ADH).

ADH is responsible for regulation of the resorption of water into the circulation
from the renal nephron. So, abnormally high levels will cause significant fluid
retention, while abnormally low levels will cause significant fluid loss from the
body.

DI commonly is caused by trauma or surgery to the brain and can result in

dehydration.

SIADH most commonly is caused by small cell lung cancer and can result in
cerebral edema.

The nurse should assess fluid intake and output, urine specific gravity, and level of
consciousness for clients with either DI or SIADH.

Nursing implementations for DI include fluid replacement and administration of

prescribed ADH replacement desmopressin or vasopressin.
 THE NCLEX CHANNEL
Nursing implementations for SIADH include fluid restriction, seizure precautions,
and fall precautions.

Prescribed therapies for SIADH include hypertonic saline and diuretics to resolve
hyponatremia and vasopressin receptor antagonists tolvaptan or conivaptan.

References:
Kaplan Nursing. (2019). Kaplan NCLEX-RN Content Review Guide (7th ed.). New
York, NY: Kaplan Publishing.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts,
D. (2016). Medical-surgical nursing: Assessment and management of clinical
problems, single volume. St. Louis, MO: Elsevier Health Sciences.