Ms. Brown is a 70-year-old woman with type 2 diabetes mellitus who has been 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 the following:
â€¢ Serum glucose 412 mg/dL
â€¢ Serum sodium (Na+) 156 mEq/L
â€¢ Serum potassium (K+) 5.6 mEq/L
â€¢ Serum chloride (Clâ€“) 115 mEq/L
â€¢Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3â€“ 20 mEq/L
Case Study Questions
1. What type of water and solute imbalance does Ms. Brown have?
2. What symptoms would be expected?
3. What would be the appropriate treatment?
4. What do her ABG results indicate?
5. Does she have an anion gap and what does this indicate?
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