In a client with SIADH, which manifestations should the nurse assess?

In the context of SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion), one of the hallmark manifestations to assess is weight gain. This condition leads to excessive retention of water due to the overproduction of ADH, which results in dilutional hyponatremia and prevents the kidneys from excreting free water. As a consequence of this water retention, patients often experience an increase in body weight.

Monitoring weight is crucial because even a small increase can indicate fluid overload, a potential complication of SIADH. It is also important to note that this weight gain is typically not accompanied by edema, as the excess fluid is primarily intravascular and not interstitial.

In contrast, polyuria, hypotension, and decreased urine specific gravity would not be characteristic of SIADH. Patients with SIADH typically have concentrated urine indicated by high urine specific gravity, and they would not present with polyuria as their kidneys are retaining water rather than excreting it. Hypotension is also uncommon since fluid retention can lead to increased blood volume and blood pressure measures. Therefore, observing for weight gain is a vital nursing assessment in managing a client with SIADH.