Question

Patient A Patient B Patient C Na+ 138 mEq/L 142 mEq/L 148 mEq/L K+ 5.1 mEq/L 6.1 mEq/L 3.8 mEq/L Ca+ 8.9 mg/dL 7.5 mg/dL 9.5 mg/dL Mg+ 1.3 mg/dL 0.9 mg/dL 2.1 mg/dL pH 7.40 7.32 7.42 PCO2 42 mm Hg 48 mm Hg 40 mm Hg PO2 95% 98% 99% HCO3 22 28 26 Patient B is complaining of numbness and tingling, especially around the mouth. What are the other two electrolyte imbalances in this patient that could be causing these symptoms? Discuss the possible etiology (cause) associated with the electrolyte imbalances identified in question number 3. What body system will attempt to compensate and how would the compensation take place?	Patient A	Patient B	Patient C
Na+	138 mEq/L	142 mEq/L	148 mEq/L
K+	5.1 mEq/L	6.1 mEq/L	3.8 mEq/L
Ca+	8.9 mg/dL	7.5 mg/dL	9.5 mg/dL
Mg+	1.3 mg/dL	0.9 mg/dL	2.1 mg/dL
pH	7.40	7.32	7.42
PCO2	42 mm Hg	48 mm Hg	40 mm Hg
PO2	95%	98%	99%
HCO3	22	28	26

   Patient B is complaining of numbness and tingling, especially around the mouth. What are the other two electrolyte imbalances in this patient that could be causing these symptoms?

Discuss the possible etiology (cause) associated with the electrolyte imbalances identified in question number 3

What body system will attempt to compensate and how would the compensation take place?

Answer 1

The two electrolyte imbalance causing numbness and tingling sensation are:

1.Hyperkalemia : normal potassium value is 3.5 to 5.0mEq/L. This patient potassium level is 6.2 mEq/L

2.Hypomagnesemia: normal magnesium level is between 1.7 to 2.2 mg/dl. In this patient magnesium level is 0.9mg/dl.

3. Hypocalcemia: normal calcium level is between 8.5 to 10.2 mg/dl. In this patient the calcium level is 7.5 mg/dl.

Possible causes: Acute and chronic renal disese, glomerular nephritis, lupus nephritis, transplant rejection, obstructive disease of urinary tract, urolithiasis, addison's disese, dehydration, destruction of red blood cells due to severe injury or burns, excessive use of potassium supplements, drugs- ace inhibitors, non steroidal anti inflamatiry drugs, angiotension 2 receptor blockers, potassium sparing diuretics.

Compensatory mechanism:

The body system responsible for compensating hyperkalemia is the kidneys. When there is excess of potassium intake, excretion will be increased. In case of renal failure the excretion of potassium is through the gut. The colon is the major site for excretion. Magnesium and calcium is effectively regulated by the kidneys. Gastrointestinal absorption is balanced by renal excretion. When there is a decrease in these ions gastrointestinal absorption, bone resorption and renal tubular reabsorption increases to normalize their levels.

Patient is in primary respiratory acidosis with secondary metabolic alkalosis.