Week 11 - SIADH Flashcards
1
Q
what are 2 disorders of the posterior pituitary gland
A
- syndrome of inappropriate antidiuretic hormone (SIADH)
- diabetes insipidus
2
Q
what is SIADH
A
- disorder due to excessive ADH secretion
- elevated ADH despite normal or low plasma osmolarity (low conc.)
3
Q
what are causes of SIADH (4)
A
- brain injury
- cancer paraneoplastic syndrome
- resp causes
- drug induced
4
Q
what types of brain injuries can cause SIADH (4)
A
- trauma
- infection
- hydrocephalus
- MS
5
Q
what are resp causes of SIADH (3)
A
- pulmonary infection
- cystic fibrosis
- asthma
6
Q
list 3 examples of drugs that can cause SIADH
A
- antiseizure
- antidepressants
- opiates
7
Q
what are the effects of antidiuretic hormone
A
- increased antidiuretic hormone –> increased water reabsorption –> increased intravascular fluid vol –> dilutional hyponatremia & decreased serum osmolality
8
Q
what are the manifestations of SIADH (4)
A
- fluid retention
- decreased urine output
- increased body weight
- symptoms of hyponatremia
9
Q
what are symptoms of hyponatremia (9)
A
- muscle cramps, twitching, and weakness
- vomitting
- abdom cramps
- anorexia
- lethargy
- confusion
- HA
- seizure
- coma
10
Q
what is considered hyponatremia
A
<134 mEq/L
11
Q
what is the urine specific gravity like during SIADH
A
- greater than 1.005 (high)
12
Q
what is the urine sodium conc during SIADH
A
> 40 with normal sodium intake
13
Q
how is SIADH diagnosed
A
- simultaneous measurements of serum & urine osmality (serum low, urine high)
- decreased serum Na
- decreased Hgb and Hct
14
Q
what are treatments for SIADH
A
- treat underlying cause
- fluid restriction
- if very symptomatic (severe confusion, seizures, coma) give hypertonic saline
15
Q
what is the role of the nurse for a pt with SIADH
A
monitor:
- sudden weight gain
- urine w increased conc
- changes in LOC
- vitals
