What is a key nursing intervention for SIADH?

• A. Strict bed rest
• B. High-dose IV fluids
• C. Administer diuretics to increase urine output
• D. Fluid restriction with monitoring of serum sodium and neurologic status

Answer: (D)

In SIADH, the problem is excess antidiuretic hormone causing the body to retain water, which dilutes the blood and lowers serum sodium, risking cerebral edema and neurologic symptoms. The best nursing intervention is fluid restriction with careful monitoring of serum sodium and neurologic status. By limiting fluid intake, you help correct the dilutional hyponatremia and reduce ongoing water retention, which is the central goal of care. As you implement this, keep a precise intake and output record, monitor daily weights, and check sodium levels regularly. Watch for changes in mental status, confusion, lethargy, headache, or seizures, and report any deterioration promptly since these signs indicate hyponatremia is slipping toward danger. Provide patient education about the rationale for fluid restriction and the importance of adhering to limits. Avoid administering large volumes of IV fluids, which would worsen hyponatremia, and recognize that diuretics are not the primary nursing intervention in SIADH and require physician orders and careful, case-by-case consideration.