Nursing care of a child diagnosed with a syndrome of inappropriate ADH should include which of the following? (Select all that apply.)
a. Weigh daily
b. Encourage fluids
c. Turn frequently
d. Maintain nothing by mouth (NPO)
e. Restrict fluids
ANS: A, E
Increased secretion of ADH causes the kidney to reabsorb water, which increases fluid volume and decreases serum osmolarity with a progressive reduction in sodium concentration. The immediate management of the child is to restrict fluids. The child should also be weighed at the same time each day. Encouraging fluids will worsen the child's condition. Turning frequently is not an appropriate intervention unless the child is unresponsive. Fluids, not food, should be restricted.
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