Registered Nurse (RN) Endocrine Licensure Exam

What complication is a concern following administration of hypertonic saline in a patient with SIADH?

1. Cerebral edema

2. Fluid overload

3. Electrolyte imbalance

4. Hypovolemia

The correct answer is: Fluid overload

Fluid overload is a significant concern following the administration of hypertonic saline in a patient with Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH). In SIADH, there is an inappropriate retention of water, leading to dilutional hyponatremia and other complications associated with excess fluid volume. When hypertonic saline is administered to correct the low sodium levels, it is essential to do so cautiously and in a controlled manner to avoid exacerbating fluid overload. Hypertonic saline works by introducing sodium into the intravascular space, which draws water out of cells and can help to normalize sodium levels. However, if too much fluid is administered too rapidly, it can lead to increased circulating blood volume, which poses a risk of congestive heart failure, pulmonary edema, and other complications associated with fluid overload. Careful monitoring of the patient's fluid status and sodium levels is crucial during treatment to prevent these serious complications. While cerebral edema, electrolyte imbalance, and hypovolemia could be relevant in different contexts of fluid management, they are not the primary concerns associated with hypertonic saline administration in this specific scenario.