A patient is admitted to the oncology unit with a small cell lung carcinoma. During the admission, the patient is noted to have a significant decrease in urine output accompanied by shortness of breath, edema, and mental status changes
The nurse is aware that this clinical presentation is consistent with: a. adrenal crisis.
b. diabetes insipidus.
c. myxedema coma.
d. syndrome of inappropriate secretion of antidiuretic hormone (SIADH).
D
SIADH may be induced by ectopic sources of antidiuretic hormone, including small cell lung carcinoma. The clinical presentation of a dilutional hypervolemia is consistent with SIADH. Adrenal crisis is characterized by fluid loss if secondary to decreased cortisol and aldosterone levels resulting in sodium loss. Diabetes insipidus is characterized by increased urine output and is not typically caused by lung tumors. Myxedema coma, although characterized by facial and peripheral edema, does not result from small cell lung carcinoma.
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