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Concepts Of Complex Nursing (NUR 426) ATI Notes- Endocrine Disorders

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John Marsh
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University of Alabama at Birmingham

Concepts Of Complex Nursing (NUR 426)

ATI Notes- Endocrine Disorders

Endocrine Disorders:
Diabetes Insipidus
 Deficiency of antidiuretic hormone (ADH—secreted by posterior pituitary)
 There is no anti-pee hormone so you can’t stop peeing
 Polyuria, polydipsia, nocturia, fatigue
 DEHYDRATION
o Sunken eyes
o Tachycardic
o Hypotension
o Loss of skin turgor
o Dry mucous membranes
o Weak, poor peripheral pulses
o Decreased cognition
 URINE CHEMISTRY IS DILUTE, SERUM CHEMISTRY IS CONCENTRATED
o Because you’re peeing out all the fluids so serum chemistries are elevated and peeing so
much so pee is diluted
 Monitor VS, UOP, CVP, I&O, specific gravity, lab studies (K, Na, BUN, Cr, sp gravity, OsM)
 DAILY weights
 Biggest complication: DEHYDRATION
o IV therapy to rehydrate
o Give desmopressin to stop the peeing
 Watch for vasoconstriction in CAD patients
 Dose adjusted based on UOP
 Monitor for water intoxication (crackles in lungs, distended neck veins, changes
in neuro state, edema, decreased UOP)
o Provide hydration & electrolyte replacement
 Promote safety, especially when ambulating to bathroom…
 Can be constipated from dehydration…give bulk foods to diet & fruits or laxatives
 Provide dry mouth care
 Encourage drinking fluids in response to thirst
 If the patient has ADH deficiency that is from tumor or nephrogenic, make sure they take
vasopressin as a life-long medication
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
 Excessive release of ADH from the posterior pituitary
 Too much anti-pee hormone so will not pee at all
 SODIUM IS EXCRETED
 Headache, weakness, anorexia, muscle cramps, & weight gain (without edema bc water is
retained, not sodium)
 Fluid volume excess
o Tachycardia
o Bounding pulses
o Possible hypertension
o Crackles in lungs
o Distended neck veins
o Taut skin

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Concepts Of Complex Nursing (NUR 426) ATI Notes- Endocrine Disorders

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