Page 1304 - Saunders Comprehensive Review For NCLEX-RN

polyuria.
d. More serious signs and symptoms
include severe muscle weakness,
diminished deep tendon reflexes,
paralytic ileus, dehydration, and
changes in the electrocardiogram.
2. Interventions
a. Monitor serum calcium level and
electrocardiographic changes.
b. Administer oral or parenteral fluids as
prescribed.
c. Administer medications that lower the
calcium level and control nausea and
vomiting as prescribed.
d. Prepare the client for dialysis if the
condition becomes life-threatening or
is accompanied by renal impairment.
e. Encourage walking to prevent
breakdown of bone.
E. Superior vena cava syndrome
1. Description
a. Superior vena cava (SVC) syndrome
occurs when the SVC is compressed or
obstructed by tumor growth
(commonly associated with lung
cancer and lymphoma).
b. Signs and symptoms result from
blockage of blood flow in the venous
system of the head, neck, and upper
trunk.
c. Early signs and symptoms generally
occur in the morning and include
edema of the face, especially around
the eyes, and tightness of the shirt or
blouse collar (Stokes’ sign).
d. As the condition worsens, edema in the
arms and hands, dyspnea, erythema of
the upper body, swelling of the veins
in the chest and neck, and epistaxis
occur.
e. Life-threatening signs and symptoms
include airway obstruction,
hemorrhage, cyanosis, mental status
changes, decreased cardiac output, and
hypotension.
2. Interventions
a. Assess for early signs and symptoms of
SVC syndrome.

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