Page 1382 - Saunders Comprehensive Review For NCLEX-RN

intoxication indicating overtreatment.
i. Instruct the client to wear a MedicAlert
bracelet.
E. Syndrome of inappropriate antidiuretic hormone secretion
(SIADH)
1. Description
a. Condition of hyperfunctioning of the
posterior pituitary gland in which
excess ADH is released, but not in
response to the body’s need for it
b. Causes include trauma, stroke,
malignancies (often in the lungs or
pancreas), medications, and stress.

c. The syndrome results in

increased intravascular volume, water
intoxication, and dilutional
hyponatremia.
d. May cause cerebral edema, and the
client is at risk for seizures.

2. Assessment

a. Signs of fluid volume overload
b. Changes in level of consciousness and
mental status changes
c. Weight gain without edema
d. Hypertension
e. Tachycardia
f. Anorexia, nausea, and vomiting
g. Hyponatremia
h. Low urinary output and concentrated
urine

3. Interventions

a. Monitor vital signs and cardiac and
neurological status.
b. Provide a safe environment,
particularly for the client with changes
in level of consciousness or mental
status.
c. Monitor for signs of increased
intracranial pressure.
d. Implement seizure precautions.
e. Elevate the head of the bed a maximum
of 10 degrees to promote venous
return and decrease baroreceptor-
induced ADH release.

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