Why is antidiuretic hormone (ADH) treatment contraindicated in a client with diabetes insipidus who has coronary artery disease?

Antidiuretic hormone (ADH) treatment is contraindicated in a client with diabetes insipidus who has coronary artery disease primarily because administering ADH can lead to fluid retention. This results in fluid overload, which can subsequently elevate blood pressure. For individuals with coronary artery disease, the risk of exacerbating their condition is significant due to the increased workload on the heart that comes from higher blood volume and pressure. This condition may precipitate heart failure or other cardiac complications, making careful fluid management essential in this population.

In clients with coronary artery disease, maintaining hemodynamic stability is critical, and introducing excessive fluid can compromise their cardiovascular status. Therefore, the cautious approach is to avoid treatments that could potentially worsen the client’s risk of complications related to heart disease.