A 32 year old woman was admitted to the hospital following 2

A 32 year old woman was admitted to the hospital following 2 & 1/2 days of severe vomiting. Before this episode she was reportedly well. Physical findings revealed decreased skin turgor and dry mucous membranes. Admission study results were as follows: What is the cause for each abnormal plasma electrolyte results? What is the significance of the urine sodium and serum osmolality results?

Solution

Q1. Plasma is the colourless part of our blood which possesses all the protein, salts, antibodies etc.., Electrolytes are the elements which exist in ion form and are required to maintain the acid-base balance and also the charge potential of our membranes e.g. sodium, potassium, chloride.

Sodium: It is important for the maintenance of water balance in our body and thus our blood pressure.The condition of low sodium levels is called hyponatremia.

Causes for low levels: Excessive water accumulation lowers the levels.Vomiting, kidney failure where excess sodium is lost through urine.

Chloride: It is important for the maintenance of fluid balance in and out of the cells, pH of the blood. The condition of less chlorine in blood is hypochloremia

cause for low levels: Vomiting, low sodium levels, respiratory acidosis due to hypoventilation i.e, low intake of oxygen which increase carbon dioxide levels.

Bicarbonate: Maintains acid-base balance in the blood because of its buffering capacity.

Cause for levels: Kidney failure, respiratory acidosis due to an increase in the carbon dioxide concentration.

Q2. Osmolality is a measure of all the dissolved chemicals/electrolytes in the blood. This is a consolidated information where one gets the overall idea about the electrolyte concentration. Osmolality values range 275-295 mOsm/kg and any change in any one of the above-mentioned electrolyte alters the overall measure of osmolality. Dehydration- loss of water from body increases this value and an excessive intake of water decreases it.This value also indicates any loss of electrolytes due to other metabolic disorders.

Low sodium levels in the urine represent high absorption of sodium from kidney and low sodium blood levels.