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Assignment:
After 3 days of nasogastric suction, Mrs. Giotta's symptoms are unrelieved. She reports continued nausea, cramps, and sometimes strong abdominal pain; her hand grips are weaker; and she seems to be increasingly lethargic. You look up her latest lab values and compare them with the admission data. Her sodium (Na) has changed from 136 to 130 mmol/L, her potassium (K) has changed 3.7 to 2.5 mmol/L, chloride (Cl) from 108 to 97 mmol/L, carbon dioxide (CO2) 25 to 31 mmol/L, BUN from 19 to 38 mg/dL, creatinine from 1 to 2.2 mg/dL, glucose from 126 to 65 mg/dL, albumin from 3.0 to 2.1 g/dL, and protein from 6.8 to 4.9 g/dL.
Which lab values are of concern to you? Why?
What measures do you anticipate to correct each of the imbalances described on question 12?
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