You are called to your patient's room by a family member who voices concern about the patient's status. On assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability
You also find 3+ pitting edema. What electrolyte imbalance would you suspect?
A) Hypercalcemia
B) Hyponatremia
C) Hyperchloremia
D) Hypophosphatemia
Ans: C
Feedback: The signs and symptoms of hyperchloremia are the same as those of metabolic acidosis: hypervolemia and hypernatremia. Tachypnea; weakness; lethargy; deep, rapid respirations; diminished cognitive ability; and hypertension occur. If untreated, hyperchloremia can lead to a decrease in cardiac output, dysrhythmias, and coma. A high chloride level is accompanied by a high sodium level and fluid retention. Option A is incorrect; with hypercalcemia, you would expect tetany. Option B is incorrect; there would not be edema with hyponatremia. Option D is incorrect; signs or symptoms of hypophosphatemia are mainly neurologic in origin.
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