Nursing and Medicine-Alterations in Endocrine Function

Nursing and Medicine-Alterations in endocrine function
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1. Patient X has polyuria with a urine volume of 8 L/day. His urine specific gravity is 1.002. His serum sodium (Na+) is 150, and his plasma osmolality is 300 mOsm/kg. He is always asking for more cold liquids to drink. What type of hormonal alteration is patient X exhibiting? What are some possible causes of this alteration? 2. How do the adrenal glands and kidneys work together to control blood pressure? Hormonal alteration is patient X
Abnormally high serum sodium concentration may be the result of losing water or even an acute gain in sodium (McCance, Huether, Brashers & Rote, 2018). Diabetes insipidus-DI (deficiency of ADH) and polyuria (frequent urination), cause water loss because of the sodium concentration. Insipidus can be neurogenic (hypothalamic), nephrogenic (renal), and polydipsic (polydipsia-polyuria syndrome) (McCance et al., 2018). There is alteration in the antidiuretic hormone (ADH) or vasopressin. Neurogenic DI is the result of insufficient amounts of ADH, and nephrogenic insipidus the kidneys do not respond to the ADH resulting in large volume of dilute urine as there are defects in the kidney tubules, it can be genetic or acquired, while in polydipsic individuals there is excessive thirst and urination. Dipsogenic diabetes insipidus occurs when there is excessive fluid intake, which lowers the plasma osmolality to levels below the osmotic ADH threshold levels (McCance et al., 2018).
When there is excessive fluid intake this increases the water load and affects the release of the ADH, and in some cases lowers the plasma osmolality below the osmotic ADH threshold levels. Anything that inhibits ADH causes increase in urine production and dehydration. Sometimes, there are disorders, which affect the ADH genes, while changes in the pituitary gland affect how the ADH functions. Renal problems worsen diabetes insipidus and kidney problems including when there s decreased response to ADH. Treating neurogenic DI depends on ADH deficiency. People with DI have abnormally low ADH secretion, and when the renal tubules are insensitive to ADH this promotes excessive loss of free water. Overall, hypos...