The Importance of Reporting Clinical Manifestations in SIADH: Identifying Electrolyte Imbalances and Fluid Status Changes

The nurse is admitting a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which clinical manifestations should be reported to the health-care provider? 1. Serum sodium of 112 mEq/L and a headache. 2. Serum potassium of 5.0 mEq/L and a heightened awareness. 3. Serum calcium of 10 mg/dL and tented tissue turgor. 4. Serum magnesium of 1.2 mg/dL and large urinary output.

For a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH), it is important to report any clinical manifestations that indicate potential electrolyte imbalances or changes in fluid status

For a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH), it is important to report any clinical manifestations that indicate potential electrolyte imbalances or changes in fluid status. Let’s analyze each option to identify which manifestations should be reported to the health-care provider.

1. Serum sodium of 112 mEq/L and a headache: This option indicates a low serum sodium level, which can be concerning as SIADH often causes water retention and dilution of sodium in the body. A low serum sodium level, also known as hyponatremia, can lead to neurological symptoms like headaches, confusion, seizures, and even coma. Therefore, this manifestation should be reported to the health-care provider.

2. Serum potassium of 5.0 mEq/L and a heightened awareness: This option indicates a normal serum potassium level, which is generally between 3.5 to 5.0 mEq/L. Heightened awareness typically refers to being more alert or vigilant, and this manifestation is not consistent with electrolyte imbalances commonly seen in SIADH. Therefore, this manifestation does not require immediate reporting to the health-care provider in the context of SIADH.

3. Serum calcium of 10 mg/dL and tented tissue turgor: This option indicates a normal serum calcium level, which is generally between 8.5 to 10.5 mg/dL. Tenting of tissue turgor refers to reduced elasticity of the skin when gently pinched, which can be a sign of dehydration. While dehydration is not a direct consequence of SIADH, it is important to ensure the client’s fluid balance is properly maintained. Therefore, this manifestation should be reported to the health-care provider.

4. Serum magnesium of 1.2 mg/dL and large urinary output: This option indicates a normal serum magnesium level, which is generally between 1.5 to 2.5 mg/dL. A large urinary output can be suggestive of diabetes insipidus, which is a separate condition from SIADH and can cause excessive urination and fluid loss. However, low magnesium levels are not typically associated with SIADH. Therefore, this manifestation does not require immediate reporting in the context of SIADH.

To summarize, the clinical manifestations that should be reported to the health-care provider in a client with SIADH are a serum sodium level of 112 mEq/L with a headache and a serum calcium level of 10 mg/dL with tented tissue turgor.

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