NCLEX-RNPhysiological AdaptationHard
A client is admitted with a serum sodium of 118 mEq/L, confusion, and concentrated urine following surgery. The nurse suspects syndrome of inappropriate antidiuretic hormone (SIADH). Which finding does the nurse expect on further assessment?
- APoor skin turgor and dry mucous membranes
- BOrthostatic hypotension
- CWeight gain without edema
- DElevated urine output with dilute urine
Show answer & explanationAnswer & explanation
Correct answer: C. Weight gain without edema
SIADH causes water retention and dilutional hyponatremia without peripheral edema because the excess fluid is intracellular and intravascular, not third-spaced; clients typically present with weight gain, concentrated urine, and normal or increased blood pressure, not signs of dehydration.
Why the other options are wrong
- A. Dry mucous membranes and poor skin turgor indicate dehydration, the opposite of SIADH's fluid retention state.
- B. Orthostatic hypotension suggests hypovolemia, not the euvolemic state of SIADH.
- D. SIADH causes concentrated (not dilute) urine with decreased urine output due to ADH excess.
SIADH
Excess antidiuretic hormone causes water retention, dilutional hyponatremia, and concentrated urine without edema.
- Causes euvolemic hyponatremia
- Urine is concentrated despite low serum sodium
- Weight gain without edema is classic
- Treatment includes fluid restriction and hypertonic saline for severe cases
Memory trick: SIADH Soaks the body but Skin stays normal