03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review

Nursing Points

General

1. SIADH (Syndrome of Inappropriate Antidiuretic Hormone)
   1. Elevated ADH (Antidiuretic Hormone)
   2. Antidiuretic hormone (ADH) make kidneys retain fluid
   3. Decreased sodium levels due to dilution
   4. Decreased osmolarity (normal 275-295) due to dilution
      1. Quick formula = sodium level x 2
   5. Decreased urine output
   6. Causes (that increase ADH)
      1. Oat cell carcinoma -> tumor in lung apices that causes ADH
      2. Viral pneumonia (hypoxia related effects on ADH levels)
      3. Issues with head
      4. Increased osmolality
      5. Anesthesia & analgesics
      6. Stress
   7. Complication -> seizure (fluid shifting into cells causing edema in brain)
   8. Treatment
      1. Restrict fluids
      2. Hypertonic solutions -> 3 percent sodium chloride (decrease cerebral edema by moving fluid out of cells)
      3. Run slow over a few hours
         Monitor for CHF
      4. Treat cause