• - is a condition in which the body develops an

excess of water and a decrease in sodium (salt)

concentration, as a result of improper chemical
signals. Patients with SIADH may become
severely ill, or may have no symptoms at all.

SYNDROME - is a collection of symptoms and

physical signs that together follow a pattern.
Assessment: Laboratory findings in diagnosis of
SIADH include:
 mild nausea  Hyponatremia <130 mEq/L, and
 loss of appetite POsm <270 mOsm/kg.
 Other findings include:
 fatigue  Urine sodium concentration >20
 Headache mEqlL (inappropriate natriuresis)
 Maintained hypervolemia
 greater weakness  Suppression of renin-angiotensin
 confusion system
 No equal concentration of atrial
 sleepiness natriuretic peptide
 vomiting  Low blood urea nitrogen (BUN)
 Low creatinine
 weight gain  Low uric acid
 possible seizure  Low albumin

 possible coma
Kidneys
 Nursing Diagnosis
• Fluid volume deficit
Nursing Management:
Fluid restriction to 800-1,000 ml/d should
be obtained to increase serum sodium.
Intravenous saline - For very symptomatic
patients (severe confusion, convulsions, or
coma) hypertonic saline (5%) 200-300 ml
IV in 3-4 h should be given.
 Medical Management
• Treating underlying causes when possible.
• Drugs
– Demeclocycline can be used in chronic situations when fluid
restrictions are difficult to maintain; demeclocycline is the most
potent inhibitor of AVP action.
– Conivaptan - an approved antagonist of both V1A and V2
vasopressin receptors. Its indications are "treatment of
euvolemic hyponatremia (e.g. the syndrome of inappropriate
secretion of antidiuretic hormone, or in the setting of
hypothyroidism, adrenal insufficiency, pulmonary disorders, etc.)
in hospitalized patients."
– Tolvaptan - an unapproved oral antagonist of the V2 vasopressin
receptor. A randomized controlled trial showed conivaptan that
can raise the serum sodium by 5 mmol/L.