Category: Critical Care and Emergency Nursing

Syndrome of inappropriate antidiuretic hormone (SIADH)

Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)

Syndrome Of Inappropriate Antidiuretic Hormone

Is a condition that results from failure in the negative feedback mechanism that regulates inhibition and secretion of ADH. It produces excess ADH, resulting hypothermia and hypoosmolality of serum. The kidneys respond by reabsorbing water in the tubules and excreting sodium; thus the patient becomes severely water intoxicated. SIADH is most commonly caused by ectopic production of ADH by malignant tumors. It can be result of CNS disorders, such as Guillain-Barre syndrome, meningitis, brain tumors, and head trauma. Pulmonary-related conditions, such as pneumonia, and positive pressure ventilation can cause SIADH. Pharmacologic agents such as general anesthetics, thiazine diuretics, oral hypoglycemics, chemotherapeutic agents, and analgesics are also associated with SIADH release.



Cardiomyopathy is a dysfunction of cardiac muscle that can be associated with coronary artery disease, hypertension, cardiotoxic agents, valvular disorders, and vascular or pulmonary diseases. Cardiomyopathies are classified into three groups by etiology and the abnormal physiology of the left ventricle.

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Aortic Dissection

Aortic dissection involves a tear in the medical layer of the aortic wall, causing blood to extravasate into the media and thus compromising blood flow to the brain, heart, and other organs. Usually the causative factor is an underlying disease of the media. Dissection can be classified by the sites involved:

1. DeBakey type I – ascending aorta beyond arch.
2. DeBakey type II – ascending aorta.
3. DeBakey type III – descending aorta.

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Cardiac Tamponade

Cardiac tamponade is the accumulation of excess fluid within the pericardial space, resulting in impaired cardiac filling, reduction in stroke volume, and epicardial coronary artery compression with resultant myocardial ischemia. Clinical sings of cardiac tamponade depends on the rapidity of the fluid accumulation and on the fluid volume.

Risk factors include recent cardiac trauma such as open trauma to the thorax (gunshot wounds and stabs), closed trauma to the thorax (impact of the chest on a steering wheel during a motor vehicle accident), cardiac surgery, and iatrogenic causes (cardiac catheterization or pacemaker electrode perforation).

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Salicylate Poisoning

Salicylate Poisoning

Salicylates Salicylates are agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs. These medications possess anti-inflammatory, analgesic, and antipyretic properties. They are available for ingestion as...