SIADH Treatment and Nursing Interventions | Nursing School Lecture

Hey there. In this video, we are walking through the nursing treatment and nursing interventions for Syndrome of inappropriate Antidiuretic Hormone, AKA siadh. Now, after this video, you'll know what the nursing interventions are and why we do them. Now, don't worry, you won't need to memorize a list of nursing interventions or treatments for your nursing school exam, but you will actually be able to understand the critical thinking behind it all. Because you know your nursing exam is not going to test you on how well you you memorize things. Right? They want to know how well you apply the information you're learning and how well you critically think about it. Think like a nurse. Right? So that is why we walk through the critical thinking behind it all, step by step. So you'll be a lot more confident for your nursing exam on SIADH after watching this video. And of course I have a free cheat sheet to help you learn things faster in nursing school. So be sure to stay until the end of the video and I will let you know where you can get that. Now hit that subscribe button and click the notification notification bell and let's dive in. Okay, so if you remember from the SIADH pathophysiology video, right here, Saadh is when there is too much antidiuretic hormone being released which tells the kidneys to hold on to water. So again, this causes two problems. There is an excess in water in the body causing fluid overload. Then there's a relative decrease in sodium because that extra water is diluting the sodium. Alright, so now that we remember that pathophysiology behind Saadh, let's take it one step further and learn about why we are going to do these interventions and the treatments. And let's dive into the critical thinking about SIADH and these interventions. So there are really two main problems that we want to correct. So here's what you'll need to do. Continue to monitor and assess them. Of course, assess your patient, especially watching for increased intracranial pressure or ICP and seizures. Check their sodium lab values. Do daily weight checks. Track intake and output. Give medications as prescribed and IV fluids as prescribed. Do IV care and educate your patients on the importance of following their plan of care, especially when it comes to a fluid restriction. Now again, let's go back into what's happening with siadh. There's too much antidiuretic hormone being released which tells the kidneys to hold on to water. This excess water dilutes the sodium levels, making them decrease. So you can probably Already See, all, all of those nursing interventions really have something to do with either fixing or tracking fluid volume or their sodium level, right? So the first thing I want you to be aware of is increased intracranial pressure, increased ICP and seizures. Because SIADH keeps the body retaining too much water, there can be too much fluid shifting into the neurological system along with a decrease in sodium because it's so diluted from all that excess water. Now, these two factors can have a huge impact, impact on nervous system function. So you must be watching out for signs of increased intracranial pressure, things like headaches, confusion, vomiting, weakness, lethargy, and other mental status changes. Really be aware of anything that seems off or isn't quite normal for your patient. So if your patient was really coherent before and you came back later and they're sleepy or can't find, find the right words or not really tracking what you're saying very well, that's a huge clue that something isn't right. And be on the lookout for seizures and implement seizure precautions. The body, especially the neurological system, loves balance. And when the neurological system gets out of balance, it can cause some pretty acute changes. So make sure you have all of the emergency equipment, all the equipment set up in the room that you would need in an emergency, things like oxygen tubing, a mask mask, all the suction equipment that you need, along with an ambu bag or manual resuscitator. Keep their bed lowered, pad the side rails and keep all of the rails up. Make sure that you have their call light, make sure they have their call light at all times. And if possible, keep them in a room that's close to the nurse's station or a room that can be video monitored so that you can catch a seizure quickly if it happens. Now, again, we know that there's too much ADH being released, so the body is holding onto too much fluid and it's decreasing the sodium level through, through dilution. So along with assessing for increased intracranial pressure and seizures, you'll need to monitor them for the common signs and symptoms of siadh. Now, these symptoms are going to go along the lines of too much water and decreased sodium levels, because that is really what is happening inside the body. With a pathophysiology of siadh. Symptoms such as weight gain, increased blood pressure, increased heart rate and a bounding pulse, decreased urine output, concentrated urine, GI disturbances. You might see things like nausea, vomiting, a loss of appetite, decreased deep tendon reflexes, neurological mental status changes. Like we talked about, things like headaches, Lethargy, confusion, seizures and a coma, low body temperature or hypothermia. We talked about those more in depth in the last video where we broke down the pathophysiology and the signs and symptoms for going step by step through the critical thinking behind why those things happen. So be sure to check that video out if you haven't yet. Now, trust me, your nursing school exam is not going to test you on how well you memorize a list of nursing interventions. No, they're going to test you on how well you critically think about the nursing interventions and apply them to a case scenario question. So that is why we break things down this way. We give you the why behind it, the critical thinking behind why you are doing these nursing interventions and treatments. Exactly what we do here, break them down for you step by step so that you can critically think about it for your nursing school exams. Now, since there is excess ADH being secreted and the fluid volume is now increased, we know that the sodium level is diluted from all that extra fluid or decreased. So on top of those assessments, you'll also need to monitor their sodium level by drawing labs. Now, a normal sodium level is between 135 and 145 milli equivalents per liter. So anything less than 135 is considered low sodium or hyponatremia. Now you'll need an accurate sodium level for the healthcare team to decide what medications to give. So drawing labs it could be really important. And make sure to do daily weight checks to monitor their fluid status. Weight is the most sensitive indicator for fluid status, so monitoring their weight will alert you to if they are holding on to too much fluid because again, there's too much ADH being secreted so the body is holding on to too much fluid. Now doing daily weight checks help us helps us make sure that their weight is trending downward and they aren't continuing to hold on to more fluid. So to do daily weight checks, you'll check their weight at the same time of day with them wearing the same clothes and using the same scale. Now that's the standard for daily weight checks to make sure that you get as accurate a read as possible. And along those same lines of monitoring their fluid status, you'll need to make sure that you are accurately measuring and recording their intake and their output. To track their fluid now measure the amount of urine that's produced along with all of the fluids that they are getting, including the IVs and all of the fluids that they are drinking. Now monitoring these things will help you notice if they are holding on to too much fluid and if you need to switch up your nursing interventions to help offload more fluid. Now we want to make sure that we get their fluid volume balanced again. So we need to make sure that we are monitoring their intake and their output accurately. The doctor may prescribe fluids or other medications, things like diuretics to help the kidneys get rid of some of that fluid, demeclocycline, which tells the kidneys not to respond to adh, therefore helping them get rid of more fluid. Possibly IV fluids such as hypertonic or isotonic solutions might be prescribed by the doctor. And now it's super important that you closely monitor your patient when giving IV fluids because fluid overload can happen fast and have very serious consequences. Things like increased intracranial pressure. Of course your patient will need a working IV and it's important to make sure that they have one at all times just in case of an emergency as well. Now you always want to make sure that you have direct IV access in order to provide life saving medications if necessary. And now this is really important. You need to do a lot of teaching with them to make sure that they know what is going on and what the plan of care is. And especially when it comes to a fluid restriction because this patient is holding onto too much fluid because they were inappropriately secreting too much antidiuretic hormone, right, that adh, siadh, inappropriate antidiuretic hormone. So they need to decrease their fluid intake to help bring the body back to a balanced state. So you need to educate them on the purpose of this and make sure that they are following the fluid restriction parameters of the doctor ordered. Encourage them to adhere to those. Now be sure to download the nursing school study checklist that I have for you that walks you through how to study in nursing school step by step. Now if you liked this video, be sure to hit that like button. Leave a comment below to let me know that you loved it. Share it with a friend. And of course click that subscribe button and hit the notification bell so you never miss a video. And click on one of these videos right over here so you can keep rocking nursing school and go become the nurse that God created only you to be. And I'll catch you the next time on the nursing school show. Take care friend. Bye bye.