Ms. Brown is an elderly woman with diabetes who was too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission her laboratory values show:
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Patient values:
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Sodium (Na+)
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156 mEq/L
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Potassium (K+)
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4.0 mEq/L
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Chloride (Cl-)
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115 mEq/L
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Arterial blood gases (ABGs):
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pH - 7.30; Pco2 - 40; Po2 - 70; HCO3- - 20
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Normal values:
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Sodium (Na+)
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136-146 mEq/L
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Potassium (K+)
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3.5-5.1 mEq/L
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Chloride (Cl-)
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98-106 mEq/L
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Arterial blood gases (ABGs):
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pH
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7.35-7.45
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Pco2
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35-45 mm Hg
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Po2
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80-100 mm Hg
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HCO3-
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22-28 mEq/L
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1. What type of water and solute imbalance does Ms. Brown have?
2. What symptoms would you expect to find?
3. What would be the treatment?