The hospice nurse has notified the family that their loved one has died.
The family is coming to view the body. Which action should the nurse take?

Managing SIADH requires understanding water metabolism and the effects of excessive antidiuretic hormone. Knowledge of fluid volume excess, dilutional hyponatremia, and neurological risks is applied to select interventions that correct electrolyte imbalances and prevent life-threatening cerebral edema.

Choice A rationale

Blood glucose monitoring is not a standard intervention for SIADH. While brain tumors can affect various hormones, SIADH specifically impacts water retention and sodium levels rather than the insulin-glucagon axis or glucose metabolism directly.

Choice B rationale

Tolvaptan is a vasopressin receptor antagonist that promotes the excretion of free water without losing electrolytes. It is specifically used in SIADH to treat euvolemic hyponatremia by blocking the effects of excessive antidiuretic hormone.

Choice C rationale

SIADH causes fluid retention and volume expansion, leading to moist mucous membranes and fluid overload. Assessing for dry membranes is more appropriate for dehydration or diabetes insipidus, which is the opposite of SIADH.

Choice D rationale

SIADH leads to dilutional hyponatremia (normal sodium 135 to 145 mEq/L). Frequent monitoring is essential because low sodium levels can lead to mental status changes, muscle twitching, and life-threatening cerebral edema if not managed.

Choice E rationale

Fluid restriction is the primary treatment for SIADH. By limiting intake, the body can slowly correct the dilutional hyponatremia. This prevents further expansion of the intravascular volume and reduces the risk of worsening hyponatremia.

Choice F rationale

Severe hyponatremia significantly increases the risk of seizures due to brain cell swelling. Implementing seizure precautions (padded side rails, suction equipment) is a critical safety measure for any patient with rapidly falling or low sodium.

End-of-life care involves applying principles of bereavement support and cultural sensitivity. Knowledge of post-mortem care and therapeutic communication is necessary. Providing a respectful environment for the family to process their loss is a core nursing responsibility in the hospice setting.

Choice A rationale

. Dismissing visitors due to being busy violates the core tenets of hospice care and bereavement support. The needs of the family are a priority following the death of a patient. Nurses must manage time to allow for family grieving and closure.

Choice B rationale

. Allowing the family to view the body in the room provides a private, familiar, and dignified setting for saying goodbye. This action supports the grieving process and is a standard of care. The room should be prepared to appear peaceful.

Choice C rationale

. Moving the body to the morgue before the family arrives is impersonal and can be distressing. The clinical environment of a morgue is not conducive to healthy grieving. Most facilities allow a period of viewing in the room first.

Choice D rationale

. Telling the family not to come is ethically inappropriate and emotionally harmful. Family presence at the time of death or shortly after is a critical component of the mourning process. Hospice philosophy emphasizes support for the entire family unit..