SIADH: A condition in which high levels of a hormone cause the body to retain water. In this condition, the body retains water instead of excreting it normally in urine. This process upsets the body's balance of minerals called electrolytes, especially sodium

1. SYNDROME OF INAPPROPRITE
ANTIDIURETICS HORMONE
PRESENTED BY: ANKITA ROY
BSC NURSING 2ND YEAR

2. Introduction
● SIADH results from abnormally high production or sustained
secretion of ADH.
● ADH is released despite normal or low plasma osmolarity.
● It is characterized by fluid retention, serum hypoosmolality,
dilutional hyponatremia, hypocholremia, concentrated urine in
the presence of normal or increased intravascular volume, and
normal renal function.
● It occurs most commonly in old adults.

3. ETIOLOGY
○ Malignant Tumors
■ Small cell lung cancer
■ Pancreatic cancer
■ Lymphoid cancer
■ Thymus cancer
■ Prostate cancer
■ Colorectal cancer
○ Central Nervous System
Disorders
■ Head injury
■ Stroke
■ Brain tumors
■ Infection
■ Cerebral atrophy
■ SLE

4. ● Medications such as Opioids, Ocytocin, Thiazide
diuretics etc.
● Miscellaneous Conditions
○ Hypothyroidism
○ Lung infections
○ Chronic obstructive pulmonary disease
○ HIV
○ Adrenal insufficiency

6. Nephron

7. PATHOPHYSIOLOGY
Increased antidiuretic
hormone
Increased water
reabsorption in renal tubules
Increased intravascular fluid
volume
Dilutional hyponatremia and
decreased serum osmolality

8. Clinical Manifestations
● Oliguria
● Water retention
● Weight gain
● Anorexia
● Nausea and vomiting
● Muscle weakness
● Lethargy
● Possible seizures
● Edema

9. Diagnostic Findings
● History collection
○ Present health history- chief complaints, onset, duration, acute or chronic
etc.
○ Past medical history- Any malignancy, surgery, HIV infection, pulmonary
disease etc.
○ Medical history- Chemotherapy, anti-depressants, diuretics etc.
○ Family history of SIADH.
● Physical examination
○ Anorexia, nausea, myoclonus, decreased reflexes, ataxia, tremor etc.
● Lab Investigations

10. Investigations
● Fluid Status
○ Assess the patient’s fluid status to identify clinical and or
biochemical dehydration.
■ Patients with SIADH are typically euvolemic or
hypervolaemic.
● Blood Tests
Serum sodium: Low in SIADH (<130 mmol/L)
Plasma osmolality: Reduced in SIADH

11. Urine Tests
● Urine osmolality >300 mOsm/kg
● Urine sodium concentration >40 mEq/L with normal dietary
salt intake.
Imaging
• Chest X-Ray and/or CT- chest: Used to rule out causes of
SIADH.

12. Management
● The primary objective in the management of SIADH is to
eliminate the underlying causes.
● Restricting the amount of fluid intake.
● Pharmacological therapy: Loop diuretics such as furosemide
(Lasix) maybe used along with fluid restriction if severe
hyponatremia is present.

13. Nursing Management
● Monitor intake and output, vital signs, and heart and lung
sounds.
● Observe for sign and symptoms of hyponatremia including
seizures, nausea and vomiting, muscle cramping, and
decreased neurologic function.
● Restrict the patients total fluid intake and obtain daily weights.
● Position the head of the bed flat or elevated no more than 10
degrees.
● Provide frequent turning, positioning and range-of-motion
exercise (if the patient is bed ridden).

14. Nursing Diagnosis
● Excess fluid volume r/t excessive amount of ADH secretion.
● Imbalanced nutrition less than body requirements r/t
nausea, vomiting and anorexia.
● Hypothermia r/t fluid overload.
● Disturbed thought processes r/t decreased levels of sodium.
● Risk of injury r/t to occurrence of seizures, coma etc.

15. Complications
● Seizures
● Coma
● Permanenet brain damage
● Fluid overload
● Decrease in osmolality
● Hyokalemia
● Hypomagnesimia
● Increased level of sodium (urine)

16. Thank You