Endocrine Flashcards
What is the most common cause of SIADH
Cancer
Pathophysiology of SIADH
increase ADH
increased water reabsorption in renal tubules
increased intravascular fluid volume
dilutional hyponatremia and decreased serum osmolality
What clinical manifestations would you see with mild hyponatremia related to SIADH
muscle cramping
irritability
headache
What clinical manifestations would you see with severe hyponatremia related to SIADH
vomiting
abdominal cramps
muscle twitching
cerebral edema (lethargy, confusions, seizures, coma)
What are the clinical manifestations of SIADH
low urine output
increased body weight
Patient has a urine specific gravity greater than 1.025, what are you worried about?
SIADH
What 3 diagnostic test do you run on a patient to determine SIADH?
Urine specific gravity
serum osmolality
serum sodium osmolality
Patient has a serum osmolality less than 280, what are you worried about?
SIADH
Patient has serum sodium level of 134, what are you worried about?
SIADH
Nursing management for SIADH
daily weights treat underlying cause give Lasix initiate seizure and fall precautions position pt flat or at 10 degrees to enhance venous return (reduces release of ADH)
What is considered mild hyponatremia
levels above 125 mEq/L
How can you manage mild hyponatremia
fluid restriction to 800-1000 mL/day
What is considered severe hyponatremia
levels below 120 mEq/L
Management of severe hyponatremia
small amounts of IV hypertonic saline given slowly
500 mL fluid restriction
Why is it important to give fluids slowly for severe hyponatremia
we do not want to increase sodium levels more than 8-12 because it can cause damage to the nerves in the brain
