The nurse is planning the care of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should be implemented? Select all that apply. 1. Restrict fluids per health-care provider order. 2. Assess level of consciousness every two (2) hours. 3. Provide an atmosphere of stimulation. 4. Monitor urine and serum osmolality. 5. Weigh the client every three (3) day
The appropriate interventions for a client diagnosed with SIADH include restricting fluids per health-care provider order, assessing level of consciousness every two hours, monitoring urine and serum osmolality, and weighing the client every three days.
1. Restrict fluids per health-care provider order: This is a crucial intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH). SIADH is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps to prevent further fluid overload and dilution of electrolytes.
2. Assess level of consciousness every two (2) hours: Frequent assessment of the client’s level of consciousness is important because hyponatremia, which is commonly seen in SIADH, can lead to neurological symptoms such as confusion, lethargy, and even seizures. Timely assessment can help detect any changes in the client’s mental status and allow for appropriate intervention.
3. Provide an atmosphere of stimulation: This intervention is not appropriate for a client with SIADH. In fact, a quiet and calm environment should be maintained for these clients. Excessive stimulation can worsen neurological symptoms and increase the risk of seizures. Avoiding loud noises, bright lights, and minimizing disturbances can help promote a safe and healing environment.
4. Monitor urine and serum osmolality: Monitoring urine and serum osmolality is essential in managing a client with SIADH. SIADH is characterized by a low urinary output and concentrated urine, as well as a low serum osmolality due to excess fluid retention. Regular monitoring of these parameters helps assess the effectiveness of treatment and guides adjustments in fluid restriction and medication therapy.
5. Weigh the client every three (3) days: Regular weighing is important for clients with SIADH as it helps monitor fluid balance and assess the effectiveness of fluid restriction. A sudden increase in weight may indicate fluid overload, while a decrease in weight may indicate excessive fluid restriction. Weighing the client every three days helps track changes in weight and informs healthcare providers about the need for adjustments in fluid management.
Therefore, the appropriate interventions for a client diagnosed with SIADH include restricting fluids per health-care provider order, assessing level of consciousness every two hours, monitoring urine and serum osmolality, and weighing the client every three days.
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