NRNP 6566 Advanced Care Of Adults In Acute Settings I week 10 knowledge check 2023-2024

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1) A 65 year old woman is brought to the ED by her family for increasing confusion and lethargy over the past week. She was recently diagnosed with small cell cancer of the lung. She has not had any f... ever or recent illness. She takes no medications at this time. PE - BP 136/82 HR 84 RR 14 T 98.2 Elderly appearing women who is difficult to arouse and reacts only to painful stimuli. She moves her extremities without apparent motor deficit. Her reflexes are normal. No JVD or extremity edema is present. Na 108 K 3.8 Bicarb 24 BUN 5 Cr 0.5 Serum osmolality 220 urine osmolality 400 CT Scan of the head shows no brain masses or hydrocephalus What is your working diagnosis? What is the next step in her treatment? My working diagnosis is syndrome of inappropriate antidiuretic hormone secretion (SIADH). The condition is caused by lung cancer (Verbaliset al., 2016). The body of the patient is producing too much ADH (Antidiuretic hormone). The hormone causes the body to retain much water. Treatment of the patient should involve vasopressin-2 receptor antagonists, water restriction, 3% hypertonic saline (513 mEg/l) for the hyponatremia, and loop diuretics with saline. [Show More]

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