SAQ 128 – Metabolic – severe hypernatraemia after seizure

Marked out of 10.00

An 87 year old man from a nursing home presents following a generalised seizure.

His observations are: BP 120/70 mmHg, HR 100 bpm, temperature 36.8 C, oxygen saturation 97% room air, GCS 12 (E4, V3, M5).

Initial blood results are shown below.

Test Result Units Reference range
Na+ 183 mmol/L 135-145
K+ 4.9 mmol/L 3.2-4.3
Cl- 137 mmol/L 99-109
HCO3- 25 mmol/L 21-28
Urea 23.5 mmol/L 2.7-8.0
Creatinine 105 micromol/L 50-100
Glucose 6.9 mmol/L 3.0-6.0
PO4 2.41 mmol/L 0.65-1.45
Ca2+ 2.39 mmol/L 2.0-2.55
Mg2+ 1.12 mmol/L 0.70-0.95

Provide two (2) calculations to help you to interpret these results.

(Marked out of 2.0)


/ 2

What is the likely cause for this clinical picture?

(Marked out of 2.0)


/ 2

Complete the following table demonstrating three (3) key treatment tasks and state how you would achieve each of these.

(Marked out of 6.0)

Key treatment task How will you achieve the task?
1.
2.
3.


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Total Score: 0 / 10

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