A nurse is preparing to administer medications to a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following medications should the nurse question?

Choice A Reason:

While monitoring the frequency of urination is important for managing diabetes insipidus, it is not the most critical aspect of discharge teaching. Diabetes insipidus causes excessive urination, and patients should be aware of this symptom. However, understanding the importance of wearing a medical alert bracelet is more crucial for ensuring immediate and appropriate care in emergencies.

Choice B Reason:

Changes in appetite are not a primary concern for patients with diabetes insipidus. The condition primarily affects fluid balance and urine output rather than appetite. Therefore, this topic is less relevant compared to the need for a medical alert bracelet.

Choice C Reason:

The benefit of a medical alert bracelet is paramount for patients with diabetes insipidus. In case of an emergency, the bracelet can inform healthcare providers about the patient’s condition, ensuring they receive appropriate and timely treatment. This can be life-saving, especially if the patient is unable to communicate their medical history.

Choice D Reason:

Weight gain or loss can be a secondary concern for patients with diabetes insipidus, as the condition primarily affects fluid balance. While it is important to monitor weight to assess fluid status, it is not as critical as ensuring the patient understands the importance of wearing a medical alert bracelet.

Choice A Reason:

A urine specific gravity of 1.010 falls within the normal range of 1.005 to 1.0301. This value does not indicate hyponatremia. In SIADH, urine is often more concentrated due to the retention of water, leading to higher specific gravity values.

Choice B Reason:

Respiratory alkalosis is not a typical manifestation of hyponatremia. It is usually associated with conditions that cause hyperventilation, such as anxiety or high altitude. SIADH typically does not cause respiratory alkalosis.

Choice C Reason:

Diarrhea is not a direct manifestation of hyponatremia. While diarrhea can lead to electrolyte imbalances, including hyponatremia, it is not a symptom caused by SIADH5. SIADH leads to water retention and dilutional hyponatremia, not diarrhea.

Choice D Reason:

Diminished reflexes are a manifestation of hyponatremia. Low sodium levels affect neuromuscular function, leading to symptoms such as muscle weakness, cramps, and diminished reflexes7. This is a direct result of the electrolyte imbalance caused by SIADH.