Hey everyone, nurse Mike here from simple nursing.com. Today we're breaking down SIADH and diabetes incipitus. The key differences made simple. But before we jump into it, for my simple nursing members, let's make sure this info actually sticks. So grab your SIDH and DI study guides from your membership and be sure to follow along. This will make it way easier to remember all the key points. All right, guys. Let's wrap up. SIADH versus DI syndrome of inappropriate antidiuretic hormone versus diabetes incipitus. So in SIADH we stop urinating and we get SI soaked inside with low liquidy labs and in DI we diares or basically drain a lot of fluid. So we get DI dry inside with high and dry lab values. Guys, a lot of anx questions come from this. So, it's important to know that it all revolves around ADH, the antid-iuretic hormone created in the posterior pituitary at the base of the brain. Our memory trick for this guy is ADH, adds to H2O. This guy keeps fluid in the body and not in the body. Now, the synthetic form of ADH or basically the man-made or drug version ends in prein like desmoprein or basop prein guys. It's given to decrease urine output and also helps to press up the blood pressure. So I just think it's pressing on the veins. But caution headaches are a huge priority since ADH adds the H2O. Guys, our labs end up low and liquidy leading to hyponetriia that low sodium below 135. We're talking swelling in the brain leading to seizures and then to death. So the big enclelex key word here is headaches guys write that down or even confusion or agitation. Usually those are the first signs of that low sodium hyponetriia. So let's break these down one by one. For siadh just think C for Spanish which basically means yes. So yes ADH yes add the H2O. So the body gets really soaked with fluid. Now guys this is super simple. Just use our memory tricks. The seven S's for SIADH. Our first S is for stop urinating. We get low urine output. And this means sticky, stinky, and thick urine. This means, keyword, high urine specific gravity, guys, over 1.030. This means we've stopped urinating. So, whatever does come out is thick like paste. Now, think SI for soaked inside or basically swollen inside. We get really low liquidy lab values with key words here hypo or low ceramos mmolality and hyponetriia or low sodium guys always huge enclelex favorites write those down. So again the enclelex is going to try and trick you. So SI think soaked inside guys low liquidy labs key words again decreased blood camos mmality and decreased sodium below 135. Next S is again for ENLEX favorite guys. Sodium that is low. I'm going to keep on harping this because the Enclelex loves to test you on this. So swelling in the brain with cerebral edema and seizures and death often the earliest signs. Big ENLEX key word here guys, headache, headache, headache, but also confusion and agitation. Next S is again for seizures from that low sodium. So guys, we set up seizure precautions for SIADH with that low sodium. Huge priority. Next is for severely high blood pressure. Since SIADH, we stopped urinating and now we're swelling inside, guys. blood pressure will be up as well as edema will be up. Which brings us to our last test, guys. We stop urinating out so we stop fluid in. Now, that's pretty simple, right? But the key word here, guys, is that we add salt to prevent those seizures from that low sodium. So, we'll stop all IV fluids except if we need to give that 3% saline or that sodium chloride via IV. And lastly, we can always give diuretics to drain that slow and fluid-filled body. But guys, that didn't even come up once throughout the 10,000 enlex questions we surveyed to build this script. So, diuretics are probably not a main intervention here. Okay, now switching gears here. Let's jump over to DI or diabetes incipitus. So, the memory trick for DI is die ADH die. Guys, ADH is dead. So, we can't add to H2O. The body ends up urinating like all over the place, peeing like a big circus elephant. So, guys, this is super simple. The patient in DI will just look very dehydrated and literally the exact opposite of that swollen SI ADH. So, guys, remember the seven Ds of DI. So DI think diaresing or draining fluid with high high urine output guys up to like 20 lers at a time. So we get very diluted urine. So very low low specific gravity less than key word here 1.005. That's a huge enclelex term. We saw this a lot. So think about all that urine coming out guys. What's happening on the inside? Well, yeah, you're getting dehydrated. So, high and dry labs. So, guys, think DI for dry inside. High dry labs here. So, Enklex key words, write these down. Hyper or high blood serum osmolality and hyperetreia, that high sodium over 145. Guys, big enlex number right there. Again, they're going to try and trick you. So again di dry inside high and dry labs very thick pasty blood with increased sodium and increased blood serum osmolality basically meaning you're going to have really thick blood now the next few D's we drink a lot of water guys patients are going to have increased thirst you also have dry dehydrated bodies with dry mucous membranes and poor sluggish skin tur as well as a big one here guys decreased increase blood pressure. Write that one down. Now, our last D and another Enclelex favorite here, D for desmopressin or ADH in drug form, also called vasop prein. So guys, remember this adds the H2O, it's ADH. So, desmopressin, think it decreases urinary output and also increases blood pressure by pressing on the veins. Now, a huge caution here, guys. It causes death again from that low sodium. So remember since desmopressin decreases urinary output, it can also decrease sodium causing deadly headaches which again leads to seizures. Now the causes of SIADH and DI are very similar. Both revolve around damage to the brain. So guys, anything that puts pressure on the pituitary since ADH is made in the pituitary. So for DI remember D for damage to the brain like tumors, trauma and even brain surgery. This can cause increased ICP or basically increased intercraanial pressure which squeezes the pituitary. Now the big difference from SIADH is the ENLEX key words here guys write this down. Small cell lung cancer and even carcinomomas and also ectopic tumors in the lung that secrete ADH. Our two other S's again are from brain damage. So severe brain trauma like NDI and even sepsis or infections of the brain like menitis and even viral pneumonia. Now for nursing care in both conditions guys we strictly monitor eyes and O's both input and output. Basically meaning how much fluid's going in versus how much is going out. Now guys this is huge since it will tell us if the drugs we're giving are working to correct the issue. So, a great indicator is Enclelex keywords, guys. Daily weights, not weekly weights. Don't let the enclelex trick you here, guys. Daily weights. Since typically weight gain means water gain, and that really goes for any condition. So, guys, if the patient is losing weight rapidly or suddenly, it usually means they're losing water rapidly or suddenly or they're gaining it, vice versa. So, guys, it's no bueno on the Enclelex. All right, guys. That wraps it up for SIDH versus DI. In this next segment, we're going to be breaking down the top four missed enclelex questions in this segment. So, let's do it. What does the nurse expect to find in a patient with syndrome of inappropriate antidiuretic hormone? Guys, select all that apply. So, before you even look at the options, look at SI ADH, syndrome of inappropriate antidiuretic hormone. Guys, I recommend to always draw out the little figure, the little fat dude. And guys, remember, we stopped urinating, so we have low urine output with very sticky, thick urine, high specific gravity. Also, if you guys drew out your little fat, dude, we have soaked on the inside for SI guys, low liquidity labs. So, sodium is going to be low. We're going to have seizures. So, let's look at our options here. Number one, we have low blood osmolality. Yes, guys, low liquidity labs. That's what we're looking for. Option number two here, increased serum osmolality. No, guys, that's DI, dry on the inside. We have low liquidity labs. Option number three, low specific gravity. No guys, in SI, we have very sticky, thicky urine. High specific gravity. Okay, what about option number four, hyponetriia? Yes, low liquidy labs. And number five is also a yes guys. Decreased urinary output. Since in SI we stopped urinating when caring for a patient in SI ADH. What does the nurse expect to implement? Select all that apply. Guys, the keywords here is SIA ADH and expect to implement. So before we even look at the options, guys, the easiest way to tackle this is the S's in SI. I'd recommend drawing a big circle with arms and legs for SIADH. It shows that our patient is really swollen and stopped urinating. So, let's recall the S's of SIADH. Guys, we stopped urinating out. So, now we have sticky, thick urine on the outside with high specific gravity. And guys, since we stopped urinating out, we stopped the fluid in. So, we get swollen on the inside, guys, with low sodium as well as seizures. So, let's select all that apply, guys. Option number one, IV maintenance fluid, guys. Normal sailing. No, guys, we stop the urine out. So, we stop the fluid in. We don't want to add to that swelling. Number two, fluid restriction. Yes, since we stopped urinating, guys, we stopped the fluid in. How about sodium restriction? No guys, we have low sodium in SI, very low liquidity labs. We need to add the sodium. Okay, how about option number four here? Seizure precautions. Yes, guys, remember the S's. We have seizures with that cerebral edema from that low sodium. And how about option number five? We monitor strict eyes and O's, guys. That's definitely yes. Always for both SI and even DI. And lastly, if you chose number six, you are completely wrong. Measure weights weekly. No guys, we're measuring daily. Enclelex will try and trick you guys. Weight gain means water gain. Not weekly, always daily. Want more insider tips and tricks for Enclelex style questions? Well, our simple nursing membership has exit prep lectures and thousands of questions covering every nursing school and enclelex topic. A client with a brain tumor develops diabetes incipitus. Which data should the nurse expect to find? Guys, keywords here, diabetes, and cipotus and expect to find. Select all that apply. Now guys, before you even look at the options, always recall what the heck is DI? Well, DI, we're diarasing or draining fluid guys. High urine output. So, we have very diluted urine. And guys, in DI, we get dry insides. So high dry labs and opposite of SIS which we get soaked inside guys low liquidy labs. So the easiest way to tackle this is to draw a little stick figure and show that he's very dehydrated in DI. So let's look at our options here. Dark urine with high specific gravity. Guys, nope. That is not DI. We're draining out a lot of fluid. We get a lot of diluted fluid with low specific gravity. Remember Si ADH has the sticky, smelly, thicky urine. Option number two, how about high blood osmolality. Yes guys, we get DI. We are dry on the inside. High dry labs. How about option three? Weight gain. No, guys, DI. We're draining water, so we have water loss. We get weight loss. Option four is correct here. Increased thirst because DI we get dry. Okay, so we have draining fluid guys, fluid loss. Option five, sodium below 135. No guys, that's low sodium. Di we get dry inside dry labs. So high sodium over 145. And guys, the last option is wrong. Urine output below 30 mls, guys. That's the bare minimum. So we have high urine output, guys. DI is draining a lot of fluid. That wraps it up for our question breakdown. Now, if you didn't know how to break down this question, or maybe you just need another review on DI versus SIDH, we have a little wrap-up video right over here. Thanks for watching. Did you know you can unlock beautifully handcrafted study guides packed with key points and memory tricks from all our videos? Plus, you'll get access to over 1,200 exclusive videos not on YouTube, all neatly organized by nursing school topic to make that complex nursing knowledge actually stick. You'll also gain thousands of practice questions written by current professors and actual ENCLEX writers. So, for access to all this and more, click right up here or visit simplening.com. And don't forget to subscribe to our YouTube channel. Happy studying and we'll see you in the next videos.