A 75-year-old man is brought to
the emergency department by his wife for evaluation of fatigue and diarrhea.
The patient was recently discharged from the hospital after treatment for right
lower extremity cellulitis. Since returning home, the patient has had multiple
episodes of profuse watery diarrhea with associated anorexia. Blood pressure is
90/73 mmHg, pulse is 132/min, and oxygen saturation is 99% on room air. The
patient appears pale and confused. On physical examination the patient has dry
mucous membranes. A urinary catheter is placed without return of urine. Which
of the following additional findings is most likely to be present in this
patient?
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