A patient with diabetes insipidus (DI) who has impaired thirst can be a challenge to manage. Such a patient may not know when or when not to drink water.


If the patient does not drink fluids, then s/he is at risk for dehydration and hypernatremia, especially during times of increased fluid loss.


If the patient receives too much fluid, then s/he may develop water intoxication and hyponatremia, especially if the dose of vasopressin is increased.



restoring thirst


maintain adequate fluids

drink a predetermined amount of fluids every few hours according to a regular schedule

control fluid loss

regular dose of vasopressin or desmopressin

adjust fluid intake

regularly monitor serum sodium

confirm adherence to regimen

record and monitor fluid intake and output

control the DI

identify cause and treat if possible


Since the patient does feel thirst there may be reluctance to drink fluids over a long period of time.


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