A nurse cares for a patient with a possible diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). The patient's serum sodium level is 114 mEq/L. What nursing action is appropriate?

Choice A rationale A serum sodium level of 114 mEq/L indicates severe hyponatremia. The normal range for serum sodium is 135 to 145 mEq/L. SIADH is characterized by an excessive release of ADH, leading to water retention and dilutional hyponatremia. Increasing dietary sodium would not correct the underlying fluid imbalance and could potentially worsen the condition by causing further fluid shifts. Choice B rationale Fluid restriction is the primary treatment for SIADH and is crucial for managing dilutional hyponatremia. By restricting fluid intake to 500 to 1000 mL/day, the nurse helps to correct the water imbalance and increase serum sodium concentration. This action directly addresses the pathophysiology of SIADH, which is characterized by water retention. Choice C rationale While measuring intake and output is important for monitoring a patient with SIADH, it is a monitoring action, not a primary intervention to correct the sodium imbalance. The instruction to assistive personnel to perform this task is part of standard care but does not address the critical need for fluid restriction in a patient with severe hyponatremia. Choice D rationale Gentle handling is a precaution for patients with hyponatremia due to the risk of cerebral edema and seizure activity. However, it is not the most appropriate nursing action to address the underlying physiological problem of fluid retention and low serum sodium. Fluid restriction is the priority action to correct the fluid imbalance and prevent complications.