Medical Surgical SIADH vs DI #4

Question

Which is the priority finding for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and should be reported immediately?

Answers

  1. 1+ Edema
    • Rationale:

      This answer is not correct because +1 edema is an expected finding for SIADH and not as concerning as the client’s headache. A headache is an early symptom of hyponatremia, which is an electrolyte imbalance that can lead to confusion, seizures, and death.

  2. UOP: 60 mL/hr
    • Rationale:

      This answer is not correct because a urinary output of 60 mL/hr is low, but not as immediately concerning as the client’s headache. A headache is an early symptom of hyponatremia, which is an electrolyte imbalance that can lead to confusion, seizures, and death.

  3. Headache: 8/10 pain
    • Rationale:

      This answer is correct because a headache is an early symptom of hyponatremia, which is an electrolyte imbalance that can lead to confusion, seizures, and death. Hyponatremia is a serum sodium level of <135 mEq/L. Decreased lab levels and symptoms of hyponatremia should be reported immediately due to the life-threatening nature of the electrolyte imbalance.

  4. BP:150/92 mm Hg
    • Rationale:

      This answer is not correct because an elevated blood pressure is expected with SIADH and this level of blood pressure (150/92 mm Hg) is not yet in the dangerous level compared to the headache, which indicates hyponatremia. A headache is an early symptom of hyponatremia, which is an electrolyte imbalance that can lead to confusion, seizures, and death.

Overview

A headache is most concerning for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH) because this is a symptom of hyponatremia. A headache is an early symptom of hyponatremia, which is an electrolyte imbalance that can lead to confusion, seizures, and death.

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 which has symptoms of headache and confusion, which then can lead to seizures and death. SIADH results from high levels of ADH, which plays a role in retention of fluid in the body.

Test Taking Tip

It is important to understand the clinical manifestations of hyponatremia to help answer this question correctly.

Video Rationale