A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH).
The nurse would monitor the client for which of the following electrolyte imbalances?
A.
Hyponatremia.
B.
Hypernatremia.
C.
Hyperkalemia.
D.
Hypokalemia.
The Correct answer and Explanation is:
The correct answer is:
A. Hyponatremia
Explanation:
Syndrome of inappropriate antidiuretic hormone (SIADH) is a condition characterized by the excessive release of antidiuretic hormone (ADH), also known as vasopressin, from the pituitary gland or other sources. ADH plays a key role in regulating water balance in the body by promoting water reabsorption in the kidneys. In SIADH, the body secretes ADH inappropriately, leading to the excessive retention of water, which dilutes the blood and causes a decrease in serum sodium levels, resulting in hyponatremia.
Hyponatremia is defined as a serum sodium level less than 135 mEq/L. In the context of SIADH, the retained water dilutes the sodium in the blood, leading to a relative deficiency. This electrolyte imbalance is a hallmark feature of SIADH and is the most critical to monitor. As the sodium levels drop, patients may experience symptoms ranging from mild (nausea, headache, and fatigue) to severe (confusion, seizures, and coma).
The other options listed are not directly related to the pathophysiology of SIADH:
- Hypernatremia (B) is an elevated sodium level, which would occur with water loss or excessive sodium intake, the opposite of what is seen in SIADH.
- Hyperkalemia (C) is an elevated potassium level and is not typically associated with SIADH.
- Hypokalemia (D) is a low potassium level, which may occur in conditions such as diuretic use or gastrointestinal losses, but it is not a primary concern in SIADH.
Management of SIADH primarily involves addressing the underlying cause, restricting fluid intake to prevent further dilution of sodium, and in some cases, administering medications such as demeclocycline or vasopressin receptor antagonists to reduce the effect of ADH. Monitoring serum sodium levels is crucial to prevent the complications of severe hyponatremia, which can be life-threatening.