Fluids and electrolytes basics

Question 1

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) definition

Answer 1

Excessive amounts of ADH secreted from posterior pituitary & ectopic sources (unregulated)

Question 2

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) etiology

Answer 2

> Ectopic production of vasopressin from malignancy
Head trauma; CVA >Increased ICP >Infections
Drugs (chemotherapy – cyclophosphamide; thiazides; phenothiazines; carbamazepine; phenytoin) >endocrine disorders (adrenal insufficiency)

Question 3

SIADH Pathophysiology

Answer 3

> water retention d/t increased ADH levels >hyponatremia d/t hemodilution
renin & aldosterone suppression d/t decreased sodium resulting in decreased reabsorption of sodium in proximal tubules

Question 4

Endocrine related lab changes with SIADH

Answer 4

1. Increased ADH

2. Increased aldosterone

Question 5

U/O with SIADH

Answer 5

Decreased (oliguria)

Question 6

Sodium with SIADH (serum & urine)

Answer 6

1. Decreased serum

2. Increased urine

Question 7

osmolality with SIADH

Answer 7

1. Decreased plasma

2. Increased urine

Question 8

What is another lab value that changes with SIADH?

Answer 8

Increased BUN

Question 9

What VS change with SIADH?

Answer 9

1. Increased HR
2. Increased BP
3. Increased RR

Question 10

Symptoms of SIADH?

Answer 10

1. Increased daily weights without edema
2. FVE
3. Increased JVD
4. Decreased GI motility (N/V)
5. Decreased DTRs
6. Weakness, fatigue
7. Headache
8. AMS changes