Mrs. A is a 46-year-old female that presents to the
Mrs. A is a 46-year-old female that presents to the ER with complaints of vomiting and diarrhea for 4 days. She has been unable to eat anything during that time. Her usual weight is 130 lbs. On admission, her weight is 121 lbs. She reports abdominal cramping, pins and needle sensations in her fingers and toes, muscle weakness, fatigue, and confusion. Assessment shows she has dry, cracked lips and poor skin turgor. Her blood pressure is 100/ 70 mm Hg, pulse 102 bpm, and respiratory rate 20. Her hematocrit level is 0.75 L/L.
Laboratory Data:
ABG’s
PH 7.30 PCO2 27 mmHg
PO2 90 mmHg bicarbonate 14 mmol/L
Sodium 3.6 Potassium 3.4
BUN 30
What signs and symptoms suggest Mrs. A is hypovolemic? (3 marks, each/1 mark)
What type of electrolyte imbalance(s) do you suspect? (2 marks, each/1 mark)
What is the normal range for this electrolyte(s)? (2 marks, each/1 mark)
What signs and symptoms/clinical manifestations would you see with this electrolyte imbalance? (3 marks, each/0.5 mark)
What tests would you do to confirm your diagnosis and why? (1.5 marks, each/0.5 mark)
What acid-base imbalance would you anticipate and why? (0.5 mark)
What clinical manifestations would you expect to see from such acid-base imbalance? (1.5 marks, each/0.5 mark)
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