A 53 year old woman has anorexia and increasing breathlessness. She has stage 4 adenocarcinoma of the lung and now requires full support with her activities of daily living. She takes diazepam, cyclizine and zopiclone.
Investigations:
- Sodium 122 mmol/L (135-146)
- Potassium 3.2 mmol/L (3.5-5.3)
- Urea 6.2 mmol/L (2.5-7.8)
- Creatinine 58 mmol/L (45-95)
Which is the most appropriate management of her electrolyte disturbance?
- 1.8% sodium chloride by intravenous infusion
- DDAVP nasally
- Demeclocycline orally
- Fluid restriction
- No treatment indicated
E. No treatment indicated
Explanation:
Although she likely has SIADH, she is asymptomatic from this and so no palliative treatment of this is necessary.