Sadie Feldman, an 85 yo woman, lives alone in a small apartment.She is on a fixed income and has little interest in cooking forherself. She eats a lot of canned food and particularly likescorned beef, sauerkraut, pickles, and cheese. She drinks blackcoffee throughout the day, but enjoys a nice cold soda at nightwith dessert. She reports being healthy most of her life but latelyhas noticed her ankles have been swollen and her rings aredifficult to remove.
Ms. Feldman visits her MD because she feels “a bit nervous” and“not quite herself.” Lab work includes a routine urinalysis andbasic metabolic panel. Physical evaluation reveals her mouth,tongue, and buccal mucosa are dry and sticky. Her skin is warm anddry. BP 150/88. T-P-R 100.8 F-96-20. She complains of feelingthirsty more than usual. She denies excess urination. Lab resultsshow: Serum Sodium (Na+) 150 meq/L.
1. Which of Ms. Feldman’s symptomsindicate an electrolyte imbalance?
2. What is contributing to Ms.Feldman’s electrolyte imbalance?
3. What physiological responsesshould occur with Ms. Feldman’s increased sodium intake?
Ms. Feldman’s MD orders a low sodium diet. What does this mean?What should be included in patient teaching? Find a reliable website to use for patient teaching.
