Complex Care: Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

What interventions should the nurse implement when caring for a client with the syndrome of inappropriate antidiuretic hormone (SIADH)? Select all that apply. A. Providing frequent oral care B. Instituting fall risk precautions C. Restricting fluids to 2 L per day D. Placing the client in the high-Fowler position E. Monitoring for and reporting neurologic changes

A. Providing frequent oral care B. Instituting fall risk precautions E. Monitoring for and reporting neurologic changes The excess production of antidiuretic hormone associated with SIADH leads to increased water reabsorption by the kidneys. Increased water reabsorption results in decreased urinary output, increased intravascular fluid volume, serum hypoosmolality, and dilutional hyponatremia. Because treatment includes restricting fluids, frequent oral care is provided to increase client comfort. Fall risk precautions are instituted to protect the client from injury that might occur as a result of neurologic changes associated with declining serum sodium. The nurse monitors for and reports changes in neurologic status resulting from cerebral edema and hyponatremia. Immediate treatment goals are to restore normal fluid balance and normal serum osmolality. Fluids are restricted to no more than 1000 mL and to no more than 500 mL for the client with severe hyponatremia. Treatment of SIADH includes placing the bed flat or elevating the head of the bed no more than 10 degrees. This position promotes venous return to the heart, which increases left ventricular filling pressure. Increasing left ventricular filling pressure stimulates osmoreceptors to send a message to the pituitary (via the hypothalamus) that antidiuretic hormone release should be decreased.

What is Specific Gravity Normal Range

1.010-1.030

What is urine osmolarity normal range

300-500mOsm/kg

A client with small cell carcinoma of the lung develops the syndrome of inappropriate antidiuretic hormone (SIADH). What signs should the nurse expect to observe? Select all that apply. A. Oliguria B. Seizures C. Vomiting D. Polydipsia E. Polyphagia

A. Oliguria B. Seizures C. Vomiting

The nurse is reviewing the labs of a new client and notes the following: serum sodium, 132 mEq/L; serum osmolarity, 280 mOsm/kg; urine osmolality, 1,500 mOsm/kg; and specific gravity, 1.035. The nurse suspects this client will be diagnosed with which condition? A. SIADH B. Diabetes insipidus C. Hypoglycemia D. Water intoxication

A. SIADH

The registered nurse is caring for a client hospitalized with syndrome of inappropriate antidiuretic hormone. Which action performed by the nurse may result in a positive outcome of the treatment? A. Obtaining the client's weight weekly B. Elevating the head of the bed to 20 degrees C. Changing the position of the client frequently D. Restricting the client's total fluid intake to 500 mL/day

C. Changing the position of the client frequently

Do BUN/Cr increase or decrease in SIADH

Decrease

In Syndrome of Inappropriate Antidiuretic Hormone (SIADH), will Serum Sodium increase or decrease

Decrease < 110 Normal Range (135-145)

In Syndrome of Inappropriate Antidiuretic Hormone (SIADH), will Serum Osmolarity increase or decrease

Decrease < 280mOsm/kg Normal Range: 275-295mOsm/kg

What medication is give for SIADH to help correct the disturbed fluid and electroylte balance

Demeclocycline

If the patient with SIADH has unstable sodium levels, the nurse would not administer which medication

Diuretics

What is the nurse HIGHEST medication administration for a patient with SIADH

Duiretics (e.g. Furosemide)

What type of IV fluids is given to a patient with SIADH

Hypertonic Solution (to concentrate the sodium levels back to normality)

In Syndrome of Inappropriate Antidiuretic Hormone (SIADH), will Specific Gravity increase or decrease

Increase > 1.020 or 1.030 (normal range: 1.010-1.030)

In Syndrome of Inappropriate Antidiuretic Hormone (SIADH), will Urine Osmolarity increase or decrease

Increase > 500 or 800mOsm/kg Normal Range: 500-800mOsm/kg

What is the common cause of Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Lung Cancer

What is the nurse HIGHEST intervention priority

Monitor for Mental Status Change

Which condition requires the nursing interventions of fluid restriction, sodium restriction, monitor serum osmolarity, monitor sodium

SIADH

A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is at risk for Hyponatermia that can result in.....

Seziures

Which condition is caused by Ectopic Secretion, bronchogenic lung cancer, recent head trauma, cerebrovascular disease, tuberculosis or other pulmonary disease and CNS infection

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Which condition presence with cerebral edema, mental status change, confusion, anger, hyponatremia, N/V, tachycardia, hypertension, crackles, bounding pulse, weight gain, water retention and decrease urinary output.

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Does Plasma Volume (ECF) increase in SIADH

Yes