A 50 kg woman who is 71 years old traveled to the emergency room after saying sh

Question

A 50 kg woman who is 71 years old traveled to the emergency room after saying she threw up and was nauseous. Tests found numbness and uniIlateral weakkness. Unfortunately, during the test she went commatose after having a seizure. Her blood work included :

A nurse infused 5 g/kg of mannitol. After equilibration, how would the body volumes change if one assumes that no excretion occurs and that the volume of the mannitol solution is 1000 ml? How would this benefit the patient chronically ? How would benefit the patient acutely?

Serum (Na+) 140 mEq/L Serum (K+) 4.2 mEq/L Serum (HCO3- ) 27 mEq/L PCO2 41 mmHg Serum creatinine 1.0 mg/dl

Explanation / Answer

If u look at the blood report ,all the variables are in normal limit

There is no abnormality that can be found in blood report.

And if we relate clinically by the signs and symptoms of the patient.it may be concluded that their may be high fluid in the brain interstitium becoz of some pathology which may have caused the seizure.thier may be raised intra cranial pressure

When mannitol is infused.as we no mannitol is a hyposomolar agent so it will draw fluid from the interstitium of the brain into blood vessels and decrease the intracranial pressure.

But mannitol is acting on other parts of the body as fluid so it will draw fluid from their also.ultimately what happens is the plasma volume increases becoz of this fluid shift.which will decrease the levels of constituents written in the blood report.

Acutely their will be benifit ,the intracranial pressure get normal

But chronically it is decreasing Na and K levels which will lead to hyponatremia,hypokalemia ,which is deadly

Decrease pco2 will lead to decrease rate of respiration

Decrease bicarbonate will lead to acidosis

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