ASSESSMENT (DIFFERENTIATION)
A patient has low urine output, weight gain, and confusion. Which disorder is most likely?
SIADH.
What is the priority intervention for a patient with SIADH?
Fluid restriction.
What hormone is deficient in Diabetes Insipidus?
Antidiuretic hormone (ADH).
What is the most dangerous complication of SIADH?
Seizures due to hyponatremia.
Why should patients with SIADH be placed on seizure precautions?
Risk of hyponatremia-induced seizures.
A patient has excessive urine output, dehydration, and intense thirst. Which disorder is most likely?
Diabetes Insipidus (DI).
What is the priority intervention for a patient with DI?
Fluid replacement.
What is the underlying problem in SIADH?
Excess ADH causing water retention.
What is the most dangerous complication of DI?
Hypovolemic shock.
Why is daily weight important in SIADH?
Best indicator of fluid retention.
A patient has serum sodium of 122 mEq/L. Which disorder is most consistent with this finding?
SIADH (hyponatremia due to dilution).
A patient with SIADH becomes increasingly confused and lethargic. What is the priority action?
Assess sodium levels and initiate precautions for hyponatremia (risk of seizures).
Why might hypertonic saline be used in SIADH?
To correct severe hyponatremia.
Why does SIADH cause neurologic symptoms?
Water shifts into brain cells causing cerebral edema.
Why is strict I&O critical in DI?
To monitor severe fluid loss and guide replacement.
A patient has serum sodium of 155 mEq/L. Which disorder is most consistent with this finding?
Diabetes Insipidus (hypernatremia due to water loss).
A patient with DI is losing 500 mL of urine per hour. What is the nurse’s priority concern?
Severe dehydration and hypovolemic shock.
What is the risk of correcting sodium too quickly in SIADH?
Osmotic demyelination syndrome.
Why does DI lead to hypernatremia?
Loss of free water concentrates sodium in the blood.
A patient with SIADH has concentrated urine but low serum sodium. Why?
Excess ADH causes water retention, diluting serum sodium while concentrating urine.
A patient has urine specific gravity of 1.002. Which condition is most likely?
Diabetes Insipidus (dilute urine).
A patient with SIADH has Na⁺ of 118 mEq/L. What is the priority treatment?
Administer hypertonic saline (3% NaCl) cautiously.
Why must fluid replacement in DI be carefully monitored?
To prevent fluid overload while correcting dehydration.
A patient with DI becomes hypotensive and tachycardic. What is occurring?
Hypovolemic shock due to fluid loss.
A nurse accidentally gives excess IV fluids to a patient with SIADH. What is the priority concern?
Worsening hyponatremia leading to cerebral edema and seizures.