SIDH and DI: Lecture Notes

Introduction

• This lecture focuses on the endocrine system, specifically the pituitary gland.
• Reference materials available on Etsy: SIDH vs DI study sheet.

Pituitary Gland Overview

• Location: Below the hypothalamus, at the base of the brain.
• Function: Produces essential hormones, specifically focusing on ADH (Antidiuretic Hormone).

Antidiuretic Hormone (ADH)

• Production: Produced in the hypothalamus, stored in the pituitary gland.
• Release Trigger: Decrease in blood volume.
• Function: Prevents water release from the body, helps retain fluids.

SIDH (Syndrome of Inappropriate Antidiuretic Hormone)

• Issue: Excessive release of ADH from the pituitary gland.
• Effect on Kidneys: Retains excess water, disrupting electrolyte balance.
• Mnemonic: "SI" for "Soaked Inside" (fluid retention).

Causes of SIDH

• Brain disorders: injuries, tumors, infections, stroke.
• Lung disease, cancer, TB, pneumonia, chronic infections, sepsis.

Symptoms of SIDH

• Reduced urine output, thick and sticky urine.
• High Urine Specific Gravity: Greater than 1.030 (high concentration).
• Labs: Hypoosmolality, hyponatremia.
• Severe symptoms: High blood pressure, edema, brain swelling, seizures.
• NCLEX Tip: Initial signs include headaches and confusion.

Treatment of SIDH

• Goal: Decrease fluid retention and improve homeostasis.
• Treatment: Hypertonic solutions for severe hyponatremia.
  • Avoid normal saline as it may lower sodium levels further.
• Nursing Considerations:
  • Monitor for seizures, implement seizure precautions.
  • Measure intake/output, daily weight.

Conclusion

• Additional resources and study sheets available for further learning.
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