65 year old Caucasian female with an admission height of 5’4” and weight of 135
ID: 128337 • Letter: 6
Question
65 year old Caucasian female with an admission height of 5’4” and weight of 135 lb. was admitted with a severe episode of CVA. Within 24 hours, her attending primary care physician placed orders for a complete metabolic panel, Mechanical Soft/Cardiac Diet, speech consult, and nutrition consult. Upon completion of the speech pathology assessment, she documented that the patient is at high risk for aspiration and inappropriate for oral feeding at this time.
Past Medical History: HTN, hysterectomy, Depression, GERD
Medications: Prilosec, Lisinopril, Zoloft
What issues are this patient’s current lab values suggesting?
Parameter
Lab Value
BUN
43
Creatinine
0.8
Sodium
153
Potassium
4.3
Albumin
3.0
Magnesium
2.8
Phosphorus
3.5
Glucose
108
Parameter
Lab Value
BUN
43
Creatinine
0.8
Sodium
153
Potassium
4.3
Albumin
3.0
Magnesium
2.8
Phosphorus
3.5
Glucose
108
Explanation / Answer
The patient’s given blood values shows that his creatinine , phosphorus and Pottassium levels are with in normal limit.But the BUN level is very high (normal range is 8- 25 mg/dl) sodium result shows hypernatremia ( normal value 135 -146 mEq/dl) albumin value is low, hypoalbuminemia. (Normal value 3.5 - 5.5g/dl) Serum magnesium level shows slight increase of 0.3 mEq/L from normal level. Blood gloucose level also slightly increased. The main symptoms of increased sodium level include brain cell shrinkage and muscle twitching and spasm.
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