一位 55 歲患有廣泛小細胞肺癌的女性，逐漸出現意識混亂、嗜睡，並主訴跳痛性頭痛。急診檢驗顯示血清鈉為 118 mEq/L。護理師應預期哪些處置？（選所有適合的）
A 55-year-old female with extensive small cell lung cancer becomes progressively confused and lethargic and reports a throbbing headache. Emergency labs reveal a serum sodium of 118 mEq/L. Which interventions should the nurse anticipate? (Select all that apply.)
- ADiagnose the client with diabetes insipidus (DI) and replace fluids aggressively.診斷病人為尿崩症（DI）並積極補充體液
- BRecognize this as Syndrome of Inappropriate Antidiuretic Hormone (SIADH).✓ 正解認知此為抗利尿激素分泌不當症候群（SIADH）
- CStrictly enforce fluid restriction.✓ 正解嚴格執行液體限制
- DEncourage the client to drink large amounts of free water.鼓勵病人大量飲用自由水
- EAnticipate administration of hypertonic saline (3%) for severe symptomatic hyponatremia.✓ 正解預期給予高張性鹽水（3%）以治療嚴重症狀性低血鈉
小細胞肺癌（SCLC）為副腫瘤症候群中 SIADH（抗利尿激素分泌不當症候群）的常見原因——腫瘤細胞異位分泌 ADH，使腎臟過度回收水分，導致稀釋性低血鈉。本題病人血鈉 118 mEq/L 加上意識變化與頭痛屬於『嚴重症狀性低血鈉』。處置：B. 認知為 SIADH；C. 嚴格限水（通常 <1 L/day）以矯正稀釋性低鈉；E. 對嚴重症狀性低血鈉給予高張食鹽水（3% NaCl）緩慢提升血鈉（每日不超過 8-10 mEq/L 以避免 osmotic demyelination）。錯誤：A. 此為 SIADH 而非 DI（DI 反為高血鈉）；D. 鼓勵病人多喝水會加重稀釋性低血鈉。
Small cell lung cancer can cause SIADH, leading to dilutional hyponatremia and neurological symptoms like confusion and headache. Interventions include recognizing SIADH, enforcing strict fluid restriction to correct water excess, and administering hypertonic saline for severe symptomatic hyponatremia.
世界級內分泌超強考點對比。「SIADH (抗利尿太多) = 尿不出來、血鈉被水分稀釋降低、腦水腫抽筋。解法 = 限水」VS 「DI 尿崩症 (抗利尿不夠)= 尿像水龍頭一直流、血鈉被濃縮飆高、嚴重脫水休克。解法 = 給水與抗利尿藥」。