The nurse is instructing a patient regarding self-management of syndrome of inappropriate antidiuretic hormone (SIADH). The patient has gastric ulceration as a comorbid condition. Which statement by the patient needs correction?

Electrolyte solutions should be taken during meals, because it dilutes the solution by allowing it to mix with the food, which prevents irritation and damage to the gastrointestinal tract. Administration of demeclocycline blocks the effect of antidiuretic hormone on the renal tubules, resulting in more dilute urine. Chewing sugarless gum and ice chips decreases thirst. Diluting the electrolyte solution before administration prevents gastrointestinal damage.

Explanation:

Completed Ques;

1.

"I should take demeclocycline as prescribed."

2

"I should chew sugarless gum and ice chips."

3

"I should drink the electrolyte solution after meals."

4

"I should dilute the electrolyte solution before administration.

"I should drink the electrolyte solution after meals

Explanation:

SIADH is due to release of large concentration of hormone  ADH into the blood streams, resulting in over re-absorption  of  ''free fluid''( that is without dissolved solutes)  from the collecting ducts and distal convoluted tubules into the blood. This raises the water potential of the blood,diluting it, and therefore  depleting it of needed minerals, especially sodium .

To make up for the depleted minerals especially sodium, electrolyte fluids should be administered. However,because of gastric ulcer co- morbidity, when electrolyte fluid is taken  directly or after meals; it interacts with the stomach  epithelial cells. Specifically,Potassium causes irritation of stomach linings, bloating, nausea, vomiting,and other complications which may aggravate the ulceration.

Therefore the patient need to be corrected that, the electrolyte fluid should be taken within meals so that as it mixed with the food, it reduces direct effects and  reaction( as listed above)   of  the electrolytes e.g potassium and other ions on the stomach linings, which may aggravate the ulceration.

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