A nurse is caring for a client who has developed Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) from cancer. Which of the following nursing interventions should be included in the client’s plan of care? (Select all that apply.)
A.
Give the client a low sodium diet.
B.
Monitor for serum electrolyte imbalances.
C.
Obtain daily weights.
D.
Educate the client on techniques to cope with thirst.
E.
Increase IV fluids.
The answer and Explanation is:
The correct answers to the question are:
B. Monitor for serum electrolyte imbalances.
C. Obtain daily weights.
D. Educate the client on techniques to cope with thirst.
Explanation:
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is a condition characterized by excessive release of antidiuretic hormone (ADH), leading to water retention, hyponatremia (low sodium levels), and diluted blood serum. This syndrome is often associated with certain cancers, especially small cell lung cancer, where tumor cells produce and release ADH.
Option A: Low sodium diet is incorrect. In SIADH, the sodium in the blood is already low due to dilution from excessive water retention. A low sodium diet would further exacerbate the hyponatremia, which could lead to serious complications such as seizures or altered mental status.
Option B: Monitor for serum electrolyte imbalances is correct. The retention of water leads to dilutional hyponatremia and possibly other electrolyte imbalances like low potassium (hypokalemia) or low magnesium (hypomagnesemia). Regular monitoring of serum electrolytes is critical to detect and manage these imbalances promptly.
Option C: Obtain daily weights is correct. Daily weight measurement is essential in SIADH as it helps to monitor fluid retention. Sudden increases in weight can indicate worsening fluid overload, which requires immediate intervention.
Option D: Educate the client on techniques to cope with thirst is correct. Fluid restriction is a primary treatment for SIADH to prevent further dilution of sodium levels. However, this can lead to significant thirst. Educating the client on methods to manage thirst, such as sucking on ice chips or using sugar-free gum, is crucial for adherence to fluid restrictions.
Option E: Increase IV fluids is incorrect. In SIADH, the main problem is water retention, so increasing IV fluids would worsen the condition by increasing the dilution of sodium in the blood, leading to more severe hyponatremia.
In conclusion, managing SIADH involves careful monitoring of electrolytes, fluid balance, and patient education to ensure effective treatment and prevent complications.