Syndrome of inappropriate antidiuretic hormone (SIADH)

Question 1

What is SIADH?

Answer 1

The body releases too much antidiuretic hormone (ADH) that causes kidneys to reabsorb too much water leading to low blood sodium level and concentrated urine

Question 2

What are some causes of SIADH?

Answer 2

Small cell lung cancer
head injuries
ICP
drugs
Guillain-Barré syndrome
Meningitis
Stroke

Question 3

What are the S/S of SIADH?

Answer 3

-Fluid volume excess: edema, crackles, pulmonary edema, dyspnea, HTN, achy, distended neck veins
-HYPONATREMIA: confusion, seizure, coma –> death
Urine = thick & concetrated
Blood = diluted, low osmolality
-LOW BUN, HGB/HCT, CREATININE

Question 4

What is the diagnosis of SIADH?

Answer 4

Serum + urine osmolality = <280

Question 5

What is the treatment of SIADH?

Answer 5

Treat underlying cause
Fluid restriction, I&Os
Diuretics

Question 6

Nursing care

Answer 6

Reduce environmental stimuli
Initiate seizure precautions
Daily weights
Keep HOB at 10 degrees or less to increase atrial filling (increases digressing effect)
Monitor sodium level
Administer IV fluids (3% NaCl)