Polyuria usually results from the use of certain drugs, such as a diuretic, or from a psychological, neurologic, or renal disorder. It can reflect central nervous system dysfunction that diminishes or supresses antidiuretic hormone (ADH) secretion, which regulates fluid balance. Or, when ADH levels are normal, it can reflect renal impairment. In both of these pathophysiologic mechanisms, the renal tubules fail to reabsorb sufficient water, causing polyuria.
Medical Causes
- Acute Tubular Necrosis (ATN)
- Diabetes Insipidus (DI)
- Diabetes Mellitus (DM)
- Glonerulonephritis (chornic)
- Postobstructive Urophathy
- Psychogenic Polydipsia
- Diagnostic Test: Transient polyuria can result from radiographic tests that use contrast media
- Drugs: Diuretics characteristically produce polyuria. Cardiotonics, vitamin D, demeclocycline, phenytoin, lithium, methoxyflurane, and propoxyphene can also produce polyuria.
Nursing Considerations
- Record intake and output, and weigh the patient daily.
- Monitor the patient's vital signs.
- Encourage the patient to drink adequate fluids and administer I.v. fluids as necessary.
- Prepare the patient for serum electrolyte, osmolality, blood urea nitrogen, and creatinine studies to monitor fluid and electrolyte status and for a fluid deprivation test to determine the cause of polyuria.
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