3 Diabetes Insipidus Nursing Care Plans

The problem in diabetes insipidus (DI) is water, not sugar. The patient cannot concentrate urine, so they dump large volumes of pale, dilute urine and drink constantly to keep up. Watch for urinary frequency, nocturia, and enuresis. The risk on the floor is that intake falls behind output: the patient dehydrates and sodium climbs. Dilute urine with low specific gravity and low osmolality is the tell.

1. Deficient Fluid Volume

May be related to

• Compromised endocrine regulatory mechanism
• Neurohypophyseal dysfunction
• Hypopituitarism
• Hypophysectomy
• Nephrogenic DI

Defining characteristics

• Polyuria
• Output exceeds intake
• Polydipsia (increased thirst)
• Sudden weight loss
• Urine specific gravity less than 1.005
• Urine osmolality less than 300 mOsm/L
• Hypernatremia
• Altered mental status
• Requests for cold or ice water

Desired outcome

• The patient maintains normal fluid volume: no thirst, normal serum sodium, and stable weight.

2. Risk for Impaired Skin Integrity

Risk factors

• High-volume urinary frequency with potential for incontinence

Desired outcome

• The patient's skin stays intact.

3. Deficient Knowledge

May be related to

• New condition
• Unfamiliarity with the disease and treatment

Defining characteristics

• Questioning
• Requests for more information
• Misconceptions or misinterpretations

Desired outcome

• The patient correctly explains DI and the medications used to treat it.