Question

Ms. Tanaka, age 76, was brought to an urgent care facility because she fell when she stood up after sitting all afternoon in her apartment where she lives alone. Although slow to answer questions, Mrs. Tanaka states she has had muscle weakness, muscle cramping, and constipation. She has had diarrhea for 3 weeks. Physical examination with Mrs. Tanaka supine revealed flat neck veins, hear rate 102 beats/min, pulse regular but weak, blood pressure 90/56 mm Hg, respirations 20 breaths/min and deep. The on-site clinical laboratory provided these results: serum sodium 142 mEq/L, potassium 2.8 mEq/L.

What fluid imbalance does Mrs. Tanaka have? What data supports that?

What imbalance is indicated by her laboratory results? What other clinical manifestations are consistent with that imbalance?

What additional electrolyte imbalance(s) might Mrs. Tanaka have? Provide supporting data.

Tanaka may have an acid-base imbalance. Which one? What aspects of her history and clinical presentation support that?

Tanaka was given intravenous isotonic sodium chloride, with appropriate electrolyte in it. What was the purpose of administering that particular fluid?

Answer 1

Answers :

1.What fluid imbalance ? what support that ?

Mrs. Tanaka have potassium fluid imbalance. Because in this scenario laboratory results shows that potassium 2.8 mE / dl, so normal level of potassium is 3.5 to 5.5 mEq / dl. She have muscle weakness, irregular heart beat that is 102 beats / mt and diarrhoea .Normally potassium helps to regulate muscle tissue . fluid will loss in diarrhoea.

Normal Serum sodium level is 135 to 145 mEq / dl.

2. What imbalance indicates by her laboratory result ?

Potassium imbalance her laboratory results that is Hypokalemia. Other clinical manifestations are :

• Palpitations
• skeletal muscle weakness or cramping
• paralysis, paresthesias
• constipation
• nausea or vomiting
• abdominal cramping
• polyuria, nocturia, or polydipsia
• psychosis, delirium, or hallucination
• depression

3. Additional electrolyte imbalance and supporting data

Mrs. Tanaka have might have magnesium imbalance also, because she is having muscle cramps.Because magnesium plays a role in muscle contraction. Deficiancy of magnesium may cause magnesium imbalance ( hypomagnesemia ). First signs of early hypomagnesemia are lethargy, weakness, muscle cramps, tetany , generalized seizures and tremor

4. Acid-base imbalance

Mrs. Tanaka may have Alkalosis acid-base imbalance. An increase in the pH of the blood is Alkalosis can cause temporary hypokalemia by causing a shift of potassium out of the plasma and interstitial fluids into the urine. In this scenario Mrs, Tanaka have history of muscle weakness and her laboratory results shows that low potassium level ( hypokalemia ).

5. Iv sodium chloride

Potassium chloride is also known as potassium salt, is used to treat and prevent low blood potassium. It may occur due to vomiting, diarrhoea or certain medications.  Potassium chloride is the drug that causes death is an implement under current lethal injection protocols.

When potasssium chloride directly injected into veins , it inflames the potassium ions in the sensory nerve fibers, leads to burning up the veins as it travels to the heart. The concentrated version should be diluted before use, otherwise it is given by slow injection into a vein or by mouth.  

Potassium chloride and sodium chloride is a combination mineral suppliment that may be helpful in reducing tiredness, muscle cramps, or heat prostration that can occur when sweat more than usual.