Nursing Diagnosis for Diabetes Insipidus

Nursing Diagnosis for Diabetes Insipidus

Diabetes insipidus (DI) is a condition which causes frequent urination. The reduction in production or release of ADH results in fluid and electrolyte imbalance caused by increased urinary output. Depending on the cause, Diabetes insipidus may be transient or life long condition. In its clinically significant forms, diabetes insipidus is a rare disease.
Clinical Manifestations

• Diabetes insipidus is characterized by increased thirst and increased urination. The primary character of DI is polyuria, excretion of large quantities of urine ( 5-20L per day)with a very low specific gravity(less than 1.005) and urine osmolality of < 100mmol/kg. In partial DI urine output may be lower(2-4L per day).
• Polydipsia (excessive intke of fluids) is also a characteristic feature of DI. Patient compensate for fluid loss by drinking great amount of water. The patient with central DI favours cold or iced drinks. Nocturia occurs due to frequent tendency to urinate which interrups sleep of the patient.
• Central DI usually occurs suddenly with excessive fluid loss. DI usually has a triphastic pattern: the acute phase with abrupt onset of polyuria, an interphase where urine volume apparently normalizes, and a third phase where DI is permanent.
• If fluid loss is not compensated, severe fluid volume de ficit results. This deficit is manifested by weight loss, hypotension, tachycardia with decreased cardiac output, poor tissue turgor, irritability, mental dullness. Hypovolemic shock may develop if fluid volume is not restored.

Nursing Diagnosis for Diabetes Insipidus

1. Fluid volume deficit related to excessive urinary output as manifested by increased thirst and weight loss.

2. Sleeping pattern disturbances, insomnia related to nocturia as manifested by verbalization of patient about interrupted sleep

3. Activity intolerance related to fatigue and frequent urination as manifested by weakness and fatigue of the patient.

4. Anxiety related to course of disease and frequent urination as manifested by verbalization of anxious questions.

5. Ineffective coping related to frequent urination as manifested by verbalization of negative feeling by the patient.

6. Risk for complications related to excessive loss of fluid from the body as manifested by hypotension and weight loss.

7. Knowledge deficit regarding management of diabetes insipidus as manifested by verbalization of doubts by the patient.

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