Critical Care Exam II || Questions and 100% Verified Answers.

Diabetes Insipidus correct answers TYPES: 1) Central a. primary - from innate ADH deficiency *b. secondary - from damage to h-h system via trauma, infection, neoplasms* 2) Nephrogenic - kidneys cant respond to circulating ADH 3) Psychogenic - from h2o tox CAUSES: (central) neurosurgery, head trauma, infection *LABS:* *- sodium 145 meq/l = hypernaturemia* *- serum Osmo 300 mos/l* * - urine Osmo 100* DX EXAMS: - water deprevation test, vasopressin test, skull XR, ct, mri CLINICAL PRESENTATION/WHY: - *sharp increase in dilute urine* - free water eliminated, hypoT and hypovolemic shock, seizures - stachy HEMODYNAMIC PRESENTATION: - low BP TX: - replace fluids via D5W or hypotonics (.9NS, .45NS, d5NS, D5.45) - replace ADH - treat underlying cause MEDS: - desmopressin/DDAVP - synthetic ADH. strong diuretic, little impact on BP - vasopressin/pitressin - hits V1 receptor so htn can result * if ADH leads to htn or overhydration, restrict fluids until urine spec grav 1.015 - mild gets diabenase, orinase, tegretol.......psychogenic gets anxiolytics COMPLICATION: htn and arterial vasospasm from ADH rx. also constipation or diarrhea SIADH correct answers CAUSES: - head trauma, CNS diseases - tumors that produce ADH, pulm disease - neurogenic stimuli, endocrine disturbances - drugs: hypoglycemics, diuretics, phenothiazine, thioxanthenes, opiates, carbmazepine, tylonol, ocy, vasopressin, anesthetics LABS: *- hypo Na 130*