The nurse is completing a physical assessment on a 55-year-old male who has been diagnosed with lung cancer. Which of the following findings should alert the nurse that the client might be experiencing superior vena cava syndrome?
1. Face and neck swelling
2. Hourly urine outputs of 250 to 500 mL
3. Calcium level of 14.0 mg/dL
4. Flat jugular veins
Face and neck swelling
Rationale: Superior vena cava (SVC) syndrome is an oncologic emergency and occurs when a lung tumor obstructs the SVC. This results in facial swelling; hand, arm, and neck swelling; distended jugular veins; cyanosis of the upper torso; and dyspnea. Hourly urine outputs of 250 to 500 mL/hour are suggestive of the complication termed syndrome of inappropriate ADH (SIADH). A calcium level of 14.0 mg/dL is considered hypercalcemia, which is a metabolic emergency associated with lung cancers.
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