Medical Surgical SIADH vs DI #3

Question

Which support the diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH)? Select all that apply.

Answers

  1. Serum sodium of 125 mEq/L
    • Rationale:

      This answer is correct because a client with SIADH will have hyponatremia or a sodium level less than 135 mEq/L. This is very dangerous and should be reported immediately.

  2. Specific gravity of 1.025
    • Rationale:

      This answer is not correct because a specific gravity of 1.025 is within normal range. SIADH symptoms will generally indicate a high specific gravity above 1.030.

  3. Blood pressure of 82/64 mm Hg
    • Rationale:

      This answer is not correct because SIADH will have an increased blood pressure, not decreased. This is due to the excessive fluid in the bloodstream.

  4. Urinary output of 370 mL in 12 hours
    • Rationale:

      This answer is correct because urinary output will be decreased in SIADH. Urinary output of 370 in 12 hours is just barely over the minimum of 30 ml/hr. This is very dangerous and should be reported immediately.

  5. Alert and oriented x1 (person)
    • Rationale:

      This answer is correct because if a client is alert and oriented x 1 (person), they are confused about where they are and what day it is. Confusion is a symptom of SIADH and should be reported immediately.

Overview

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) has symptoms which include hyponatremia, increased urine specific gravity (>1.030), hypertension, low urine output, and confusion.

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, decreased urine output, increased urine specific gravity, and heart failure. SIADH also presents with hyponatremia, confusion, 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

Remember that SIADH means the client is “soaked” and the bloodstream will be overloaded with fluid so hyponatremia will occur. This is serious and should be reported immediately.

Video Rationale