What pathologic process is most likely occurring in a client who has a serum sodium level of 122 mEq/L and a serum potassium level of 6.6 mEq/L?
A. Adrenal insufficiency
B. Chronic renal failure
C. Cushing's syndrome
D. SIADH
A
Aldosterone is secreted by the adrenal cortex. It enhances the reabsorption of sodium and the excretion of potassium at the same time. People with adrenal insufficiency secrete very little, if any aldosterone. As a result, sodium is excreted and potassium is reabsorbed leading to hyponatremia with hyperkalemia. SIADH would dilute all electrolytes and result in hyponatremia with hypokalemia. Cushing's syndrome acts like aldosterone, leading to hypernatremia and hypokalemia. Chronic renal failure would impair the excretion of both sodium and potassium, leading to hypernatremia and hyperkalemia.
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