Fluid, Electrolyte and Acid-Base Homeostasis

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:

  • Serum glucose 412 mg/dL
  • Serum sodium (Na+) 156 mEq/L
  • Serum potassium (K+) 5.6 mEq/L
  • Serum chloride (Cl–) 115 mEq/L
  • Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3– 20 mEq/L

Case Study Questions

  1. Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?
  2. Describe the signs and symptoms to the different types of water imbalance and described clinical manifestation she might exhibit with the potassium level she has.
  3. In the specific case presented which would be the most appropriate treatment for Ms. Brown and why?
  4. What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?
  5. Based on your readings and your research define and describe Anion Gaps and its clinical significance.
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