welcome back to part two of sidh versus di let's continue where we left off let's look at the complete opposite now and that's di or diabetes insipidus diabetes insipidus is a condition in which the hypothalamus produces not enough antidiuretic hormone so the pituitary gland has no ADH to release remember antidiuretic means we are not diuresing AKA we are holding in water so if we don't have enough ADH being released during diabetes insipidus the kidneys cannot conserve water in the body and now we are losing more water than is desired which upsets the body's balance of electrolytes you can remember this by thinking di for dry inside you are losing fluids and becoming like SpongeBob in that one episode where he's begging for water now why does this happen why would someone be diagnosed with di common situations where the body releases not enough ADH include damage to the hypothalamus or pituitary gland during surgery or radiation disorders of the brain just like an sidh nclex-tip brain injury caused by increased intracranial pressure suppresses the pituitary gland function other conditions include lung disease cancer TB pneumonia and chronic infections symptoms of di revolve all around that dried out little SpongeBob sitting on the toilet if the body is peeing out so much fluid urine output will be increased which is what we call polyuria if we're peeing out tons of fluid then we have extremely diluted urine think about when you drink a ton of water and you pee that out your pee is clear right a little tip for the NCLEX this is what we call low urine specific gravity it is so diluted it's going to be less than 1.005 now if we are losing fluids we are dehydrating our insides right we are dry inside which means common Labs would show hyperosmolality and hypernatremia the patient will have dry skin and dry mucous membranes with decreased blood pressure and of course they're very thirsty like SpongeBob in that episode so you've been diagnosed with di now how do you treat it the goal is to increase fluid retention and improve tonicity homeostasis if the body is not naturally producing or releasing enough ADH we need to give the patient a man-made form of ADH right these drugs end in pressin like desmopressin and vasopressin think these drugs will press or contract the renal ducts to decrease urine output and increase fluid in the body to balance water and sodium another way to increase fluids in the body tell the patient to drink water if oral intake is inadequate administer dextrose and normal saline slowly to avoid fluid volume overload or hyperglycemia and of course we have the same nursing considerations for Di as we do for sidh last little tidbit to wrap up sidh and Di in both conditions we're messing with our sodium to water ratio right and sidh the patient is soaked inside which dilutes many substances in the blood such as sodium in di the patient is dry inside which causes more sodium than total body water for the NCLEX remember that the brain is particularly sensitive to changes in sodium level so we monitor for neurologic changes to prevent seizures and death early signs headache confusion lethargy and hyponatremia and late signs if sodium levels fall quickly the patient will experience muscle twitching and seizures if untreated we'll see unresponsiveness coma or death and that wraps up our lecture on sadh and Di I see you pausing this video taking notes left and right you don't need to do that everything you heard is available in studysheet form on my Etsy Shop check it out I love it that's great yeah like subscribe