Ms. Tanaka, age 76, was brought to an urgent care facilitybecause she fell when she stood up after sitting all afternoon inher apartment where she lives alone. Although slow to answerquestions, Mrs. Tanaka states she has had muscle weakness, musclecramping, and constipation. She has had diarrhea for 3 weeks.Physical examination with Mrs. Tanaka supine revealed flat neckveins, hear rate 102 beats/min, pulse regular but weak, bloodpressure 90/56 mm Hg, respirations 20 breaths/min and deep. Theon-site clinical laboratory provided these results: serum sodium142 mEq/L, potassium 2.8 mEq/L.
What fluid imbalance does Mrs. Tanaka have? What data supportsthat?
What imbalance is indicated by her laboratory results? Whatother clinical manifestations are consistent with thatimbalance?
What additional electrolyte imbalance(s) might Mrs. Tanakahave? Provide supporting data.
Tanaka may have an acid-base imbalance. Which one? Whataspects of her history and clinical presentation supportthat?
Tanaka was given intravenous isotonic sodium chloride, withappropriate electrolyte in it. What was the purpose ofadministering that particular fluid?
