Rita is a 105 pound 19 year-old college student who, as part ofa sorority hazing ritual, attempted to drink 2 gallons of waterover a 1 hour period. She made it through 1.5 gallons before shebegan vomiting, became disoriented, and started slurring herspeech. Others at the party didn’t think much of her behaviors,until she collapsed and began having seizures. 911 was called andshe was rushed to the hospital. In the emergency room, Rita wassemi-comatose, responding only to painful stimuli. Her vital signswere stable, and a review of other systems noted no abnormalities.Blood and urine labs were ordered, with the following results:
Na+: 109 mEq/L K+: 4.0 mEq/L Chloride: 88 mEq/L CO2: 20 mEq/LBlood urea nitrogen (BUN): 9 mg/dL Creatinine: 1.0 mg/dL Glucose:105 mg/dL Serum osmolality: 229 mOsm/kg H2O Urine osmolality: 80mOsm/kg H2OQuestions (1 point each)1. List Rita’s abnormal labvalues, along with their normal ranges
.2. What 2 conditions is Rita simultaneously suffering from?
3. What lab values support these diagnoses?
4. This condition can cause brain damage secondary to cerebraledema. Explain, in detail, the mechanism by which cerebral edemaoccurs in the setting of these diagnoses.
5. What will the treatment be for this patient?
