The nurse is reviewing information in the medical record of a patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of these manifestations should the nurse investigate first when assessing this patient?
Laboratory report:
Serum sodium 115 mEq/L
History and physical:
Patient reports fell from bicycle and struck head 5 days ago
Pulse:
100
Blood pressure:
140/95
Previous 24-hour intake and output:
3,500 mL in, 1,500 mL out
1. The patient is lethargic and difficult to wake.
2. The patient states, "I feel thirsty."
3. The patient states, "I have a headache."
4. The patient's urine is dark amber in color.
Correct Answer: 1
Manifestations of SIADH are usually nonspecific but are related to hyponatremia and water intoxication. SIADH may occur with a head injury. Cerebral edema develops, causing changes in mental status such as lethargy. Despite fluid retention, the patient may experience thirst. Headache and dark urine are common symptoms of this disorder.
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