SYMPTOM OF INAPPROPRIATE ANTIDIURETIC HORMONE

Question 1

what is SIADH?

Answer 1

excessive release of ADH which causes urinary retention

Question 2

what are clinical manifestations of SIADH?

Answer 2

1. weight gain because water is being retained
2. dark yellow concentrated urine
3. cheyne stokes respirations
4. manifestations of FVE (, tachycardia, bounding pulses, and hypertension)
5. sluggish deep tendon reflexes

Question 3

what are lab findings for a patient with SIADH?

Answer 3

1. decrease in sodium levels throughout the body

2. increase in urine specific gravity which will be >1.005

Question 4

what is the plan of care for a patient with SIADH?

Answer 4

1. fluid restriction of 500-1000 mL/day
2. monitor I&Os very closely, vitals and daily weights and teach that a weight gain of 2 lb in a day or 5 lb in a week is abnormal and the doctor should be notified
3. monitor neuro status such as confusion, lethargy, seizures–> due to hyponatremia
4. seizure precautions

Question 5

what is a possible complication of SIADH?

Answer 5

heart failure can develop to due fluid overload–> loop diuretics

Question 6

what fluids can be given to these SIADH patients?

Answer 6

hypertonic solution (3%). give 200-300 mL slowly at a rate of 20-40 ml/hour because giving it too quickly can cause neurological problems

Question 7

what medication can be given for SIADH?

Answer 7

demeclocycline can be given to help stimulate urine flow