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🤔 Critical Thinking 🤔 A patient 48 hours after TBI has urine output 300 mL/hr, Na⁺ 151, serum osmolality high, urine osmolality low. What is the priority? A. Fluid restriction B. Furosemide C. Free water replacement and notify provider D. Hypertonic saline Massive urine output rising sodium after head injury = the brain is losing water fast. Before this turns into neurologic damage, what’s your priority? #nclexhighyield #questionoftheday #nclexprep #nursingstudents #futurenurse #nursingschool
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🤔 Critical Thinking 🤔 A patient 48 hours after TBI has urine output 300 mL/…
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Study Smarter with MedSchoolBro on Instagram: "Code HAVC @medschoolbro = Mystery Discount Diabetes Insipidus: the 30-sec Flow Step 1: Water deprivation → urine osm ↑ = Primary polydipsia (Na normal/low). No change? Give desmopressin. Osm ↑ with DDAVP → Central DI (↓ ADH) → intranasal DDAVP + hydration. Still no change → Nephrogenic DI (renal resistance) → thiazide + NSAID; fix Li⁺. Pearl: DI = dilute urine; watch serum Na. #drhavicandbrody #medstudent #medschool #medicalstudent #medicalschool us
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SIADH vs DI 💧🧠 (Posterior Pituitary Disorders) I always think of ADH as “holding on to water.” If you remember that, these disorders are way easier to understand ⬇️ SIADH = TOO MUCH ADH 👉 Body holds too much water • Dilutional hyponatremia • Low serum osmolality • Concentrated urine • Weight gain, no edema DI = TOO LITTLE ADH (or kidneys don’t respond) 👉 Body can’t hold water • Hypernatremia • High serum osmolality • Very dilute urine • Extreme thirst & dehydration Key memory trick 🧠 ADH =
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