Question

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).

Answer 1

The symptoms exhibited by the patient suggest the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), caused by excessive release of ADH leading to water retention and hyponatremia.

Step-by-step explanation:

The clinical presentation of a patient with small cell lung carcinoma who has decreased urine output, shortness of breath, oedema, and mental status changes suggests the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). SIADH is characterized by the excessive release of antidiuretic hormone (ADH) from the posterior pituitary gland, leading to water retention, hyponatremia, and the dilution of blood serum. In contrast, diabetes insipidus is marked by the insufficient production of ADH, resulting in frequent urination and thirst due to the inability of the kidneys to retain water.

Patient symptoms such as oliguria, which is the excretion of less than 600 ml/day of urine, can be caused by conditions like fever, shock, and severe dehydration. In the context of SIADH, the decreased urine output is associated with fluid retention and not dehydration.