Syndrome of inappropriate antidiuretic hormone secretion occurs when excessive levels of antidiuretic hormones (hormones that help the kidneys, and body, conserve the correct amount of water) are produced. The syndrome causes the body to retain water and certain levels of electrolytes in the blood to fall (such as sodium). SIADH is rare in children.
SIADH tends to occur in people with heart failure or people with a diseased hypothalamus (the part of the brain that works directly with the pituitary gland to produce hormones). In other cases, a certain cancer (elsewhere in the body) may produce the antidiuretic hormone, especially certain lung cancers. Other causes may include the following:
Meningitis (inflammation of the meninges, the membranes that cover the brain and spinal cord)
Encephalitis (inflammation of the brain)
Brain tumors
Psychosis
Lung diseases
Head trauma
Guillain-Barré syndrome (a reversible condition that affects the nerves in the body. GBS can result in muscle weakness, pain, and even temporary paralysis of the facial, chest, and leg muscles. Paralysis of the chest muscles can lead to breathing problems.)
Certain medications
Damage to the hypothalamus or pituitary gland during surgery
Thyroid or parathyroid hormone deficiencies
HIV
Hereditary causes
Each person may experience symptoms differently. Symptoms, in more severe cases of SIADH, may include:
Nausea or vomiting
Cramps or tremors
Depressed mood,memory impairment
Irritability
Personality changes, such as combativeness, confusion, and hallucinations
Seizures
Stupor or coma
The symptoms of SIADH may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.
In addition to a complete medical history and physical examination, to confirm diagnosis of SIADH, blood and urine tests will need to be performed to measure sodium, potassium, and osmolality (concentration of solution in the blood and urine).
Specific treatment for SIADH will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
The most commonly prescribed treatment for SIADH is fluid and water restriction. If the condition is chronic, fluid restriction may need to be permanent. Treatment may also include:
Certain medications that inhibit the action of ADH (also called vasopressin)
Surgical removal of a tumor that is producing ADH
Other medicines to help regulate body fluid volume
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16. A male client is admitted for treatment of the syndrome ofinappropriate antidiuretic hormone (SIADH). Which nursingintervention is appropriate?A. Infusing I.V. fluids rapidly as orderedB. Encouraging increased oral intakeC. Restricting fluidsD. Administering glucose-containing I.V. fluids as ordered
17. A female client has a serum calcium level of 7.2 mg/dl. During thephysical examination, nurse Noah expects to assess:
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18. Which outcome indicates that treatment of a male client withdiabetes insipidus has been effective?
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19. Jemma, who weighs 210 lb (95 kg) and has been diagnosed withhyperglycemia tells the nurse that her husband sleeps in another roombecause her snoring keeps him awake. The nurse notices that she haslarge hands and a hoarse voice. Which of the following would the nursesuspect as a possible cause of the client’s hyperglycemia?
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20. Nurse Kate is providing dietary instructions to a male client withhypoglycemia. To control hypoglycemic episodes, the nurse shouldrecommend:A. Increasing saturated fat intake and fasting in the afternoon.B. Increasing intake of vitamins B and D and taking iron supplements.
C. Eating a candy bar if lightheadedness occurs.D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.21. An incoherent female client with a history of hypothyroidism isbrought to the emergency department by the rescue squad. Physicaland laboratory findings revealhypothermia, hypoventilation,respiratory acidosis, bradycardia,hypotension, and nonpitting edemaof the face and pretibial area. Knowing that these findings suggestsevere hypothyroidism, nurse Libby prepares to take emergency actionto prevent the potential complication of:
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22. A male client with type 1 diabetes mellitus asks the nurse abouttaking an oralantidiabeticagent. Nurse Jack explains that thesemedications are only effective if the client:
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