In SIADH with hyponatremia, what is a common nursing intervention?

• A. Fluid restriction
• B. Increase free water intake
• C. Administer diuretics without orders
• D. High-sodium diet

Answer: (A)

In SIADH, excess antidiuretic hormone makes the body hold onto water, leading to dilutional hyponatremia. The most common nursing intervention is fluid restriction, which limits free water intake and helps concentrate the blood sodium toward normal levels. By reducing the amount of water the kidneys reabsorb, sodium can gradually rise, and the risk of cerebral edema from severe hyponatremia decreases. Throughout this process, closely monitor fluid balance, daily weights, serum sodium, and neurological status, and avoid rapid correction to prevent osmotic demyelination syndrome.

Increasing free water intake would worsen the hyponatremia by further diluting sodium. Giving diuretics without orders is unsafe and not appropriate without a physician’s directive. Relying on a high-sodium diet alone does not address the underlying water retention and hyponatremia and is not the primary nursing intervention.