Registered Nurse (RN) Endocrine Licensure Exam

Which of the following would be a potential nursing diagnosis for a patient with SIADH?

1. Fluid volume overload

2. Fluid volume deficient

3. Acute pain

4. Impaired skin integrity

The correct answer is: Fluid volume overload

Fluid volume overload is an appropriate nursing diagnosis for a patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion) due to the excessive retention of water resulting from high levels of antidiuretic hormone (ADH). In SIADH, the body retains more water than it should, leading to dilutional hyponatremia and an increase in total body water, which can cause symptoms such as weight gain, edema, hypertension, and a reduced serum sodium concentration. The excess fluid can overwhelm the body's capacity to handle it, leading to a clinical picture consistent with fluid overload. In contrast, the other choices do not align with the pathophysiology of SIADH: fluid volume deficient would indicate dehydration or insufficient fluid, acute pain pertains to discomfort which may not relate to fluid status, and impaired skin integrity is more associated with conditions leading to skin breakdown rather than fluid balance issues. Understanding these distinctions helps nurses provide better patient care by identifying and addressing the correct nursing diagnoses.