ATI Endocrine Questions and Answers Latest Update 2024

Diabetes Insipidus & ADH - Too little antidiuretic hormone (ADH) SIADH & ADH - Too much antidiuretic hormone (ADH) DI Manifestations - - Polyuria - Urine output 5-20 L/day - Polydipsia - Drinking 4-30 L/day - Dehydration - Poor skin turgor, dry mucous membranes, hypotension, tachycardia, wt. loss, headache, dizziness, constipation - Hypovolemic shock - hypotension, tachycardia, decreased CO, decreased cerebral perfusion SIADH Manifestations - - Oliguria - excretion of Na+, reabsorption of water - Fluid volume excess - wt gain w/o edema, crackles, distended neck veins, taut skin, tachycardia, HTN - Early manifestations - headache, weakness, anorexia, muscle cramps, wt gain - Late manifestations - personality changes, hostility, decreased deeptendon reflexes, n&v, diarrhea, confusion, lethargy, Cheyne-Stokes respirations, seizures, coma, deathDI (Urine & Serum Concentration) - URINE DILUTE/SERUM CONCENTRATED Urine • Specific gravity less than 1.005 • Low osmolality (50-200 mOsm/kg) • Decreased pH • Decreased urine sodium • Decreased urine potassium Serum • Increased serum osmolality (greater than 295 mOsm/kg) • Increased serum sodium • Increased serum potassium • Serum Na+ & K+ are high only because serum is concentrated SIADH (Urine & Serum Concentration) - URINE CONCENTRATED/SERUM DILUTE Urine • Specific gravity greater than 1.025 • High osmolality (greater than 295 mOsm/kg) • Increased urine sodium • Increased urine potassium