Week 5 - SIADH

Question 1

Is ADH released despite low or normal serum osmolality?

Answer 1

yes

Question 2

What is the cause of SIADH? (4)

Answer 2

1. Malignancies
   - ADH-secreting tumour
   - pituitary tumour
2. CNS disorders
   - meningitis
   - brain trauma
3. Pulmonary disorders
4. Drugs

Question 3

SIADH flow chart

Answer 3

think: SIADH = Soaked Inside

Question 4

What are the clinical manifestations of SIADH (2, 6)

Answer 4

1. fluid retention
   - decreased urine output and increased body weight
2. Symptoms are primarily related to decreased Na+ (CNS)
   - muscle cramps, twitching and weakness
   - vomiting, abdominal cramping, anorexia
   - lethargy, confusion, headache, seizure, coma

Question 5

How is SIADH diagnosed? (2)

Answer 5

• simultaneous measurements of serum and urine osmolality
• serum osmolality decreased (plasma, hyponatremia)
• urine osmolality increased (not peeing)

Question 6

What other lab results can diagnose SIADH? (2)

Answer 6

• decreased serum Na+
• decreased Hgb and Hct

Question 7

What do nurses monitor for in SIADH? (4)

Answer 7

• sudden weight gain
• urine with increased retention
• change in LOC
• vital signs

Question 8

What is the treatment for SIADH? (3)

Answer 8

• treat underlying cause
• fluid restriction
• diuretics