Medical Surgical SIADH vs DI #1

Question

The nurse is caring for a client who came to the emergency department with a diagnosis of acute syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which nursing diagnosis is most important to use prior to treatment?

Answers

  1. Risk for thromboembolism
    • Rationale:

      This answer is not correct because venous thrombosis is not as likely to occur and is not the priority at this time. On one hand, the excess fluid would keep the blood from being as likely to clot but on the other hand, the excess fluid volume may make the client less mobile, which could make the client at risk for venous thrombosis. Regardless, the client’s priority treatment is for fluid volume excess.

  2. Risk for infection
    • Rationale:

      This answer is not correct because risk for infection is not associated with SIADH. The client’s primary symptoms are related to the excess fluid volume. Too much of ADH makes the body hold on to too much fluid and cause fluid volume excess. This can lead to fluid volume overload, edema, tachycardia, hypertension, and heart failure. SIADH also presents with hyponatremia, possible seizures, and low urine output.

  3. Activity intolerance
    • Rationale:

      This answer is not correct because although activity intolerance may become a nursing diagnosis if excess fluid volume persists, it is not the priority issue to be treated. If fluid volume excess is not treated immediately, heart failure could develop.

  4. Fluid volume excess
    • Rationale:

      This answer is correct because SIADH is a condition where there is too much antidiuretic hormone in the body. The antidiuretic hormone holds on to water normally to make the client not diurese too much and become dehydrated. Too much of ADH makes the body hold on to too much fluid and cause fluid volume excess.

Overview

In SIADH, too much ADH makes the body hold onto too much fluid and causes fluid volume excess. This can lead to various problems associated with fluid volume overload, edema, tachycardia, hypertension, and heart failure.

Explanation

Learning Outcomes

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition where there is too much antidiuretic hormone in the body. The antidiuretic hormone holds on to water normally to make the client not diurese too much and become dehydrated. Too much of ADH makes the body hold on to too much fluid and cause fluid volume excess. This can lead to fluid volume overload, edema, tachycardia, hypertension, and heart failure. SIADH also presents with hyponatremia, possible seizures, and low urine output. The condition results from high levels of ADH, which plays a role in retention of fluid in the body.

Test Taking Tip

To help remember that SIADH has fluid volume excess, think of “Soggy SID” for SIADH.

Video Rationale