Diabetes Insipidus: A Case Study

Superior Essays
1. A 35-year-old male has come to see you because he is urinating, by his estimate, about 8L/day. He is constantly thirsty and drinks as much cold water as he can every day. His sleep is disrupted because of the need to urinate throughout the night. During your assessment, you learn he had several concussions playing college sports. He was recently involved in a car accident in which the airbag deployed and knocked him out. You test his urine and the specific gravity is 1.002. Stat labs reveal a serum sodium (Na+) of 150, and his plasma osmolality is 310 mOsm/kg.

a. What hormonal imbalance does this patient have?
This male patient has Diabetes Insipidus, (DI), more specifically, Neurogenic (Central) DI. Diabetes Insipidus is “an insufficiency
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It is produced in the hypothalamus and stored in the pituitary gland. ADH is released from the pituitary gland and acts on the kidneys to prevent the loss of excess fluids through urination. ADH operates on “transmembrane protein called aquaporin that open up to allow water into collecting ducts” (Mandal, 2013, p. 1). In Neurogenic (Central) DI, extremely low ADH is unable to prevent the kidney from passing dilute urine resulting in polyuria and manifesting in polydipsia. The elevated sodium serum level is an indication of dehydration due to the lack of ADH resulting in an imbalance between sodium and water concentration in the …show more content…
Describe which blood types he can receive safely and why these are compatible with his Type B

Blood types are distinguished by the presence or absence of antigens (A and B) on the surface of the red blood cells. This patient has Type B blood meaning that there is only a B antigen on his red blood cells. The compatible blood types are Type B since it matches the patient’s blood type and Type O negative, which is considered universal. Type O negative blood does not contain antigen A or B, therefore it is more likely to be compatible with all blood types.

c. Describe the blood types he cannot receive and why they are incompatible with Type B

Type B blood is incompatible with Type A and Type AB blood types since it does not contain the same antigen on its red blood cells. There is an antibody to the A antigen, therefore giving blood containing the A antigen (including AB blood) will cause an adverse reaction

d. Explain the transfusion reaction if he received incompatible blood products
The infusion of an incompatible blood product can trigger an immune response in the patient as the body attacks the A antigen. Incompatibility will lead to clumping of red blood cells that can block blood vessels to vital organs. “An acute hemolytic transfusion reaction begins to destroy the donated red blood cells resulting in fever, pain, and sometimes sever complications such as kidney failure”("Blood Safety," 2013, p. 1). Death can occur if immediate action is not

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