Question

A 39 year-old woman is brought to the emergency department by her husband. She is conscious but confused and keeps repeating that her head hurts so much she feels it might “explode.”   The husband tells you that she has no health problems and takes no medications other than aspirin for occasional pain. He also tells you that she entered a contest earlier today to try and drink the most water in 1 hour. She drank 10 glasses but did not win the contest and came home. Her confusion and headache started about an hour later.

What type of fluid or electrolyte imbalance is she likely to have and from what cause? Explain your answer.

What physical assessment data are the priority to obtain? Explain.

What laboratory data would you expect to be ordered?

Is this patient at risk for heart failure or pulmonary edema? Why or why not?

A 39 year-old woman is brought to the emergency department by her husband. She is conscious but confused and keeps repeating that her head hurts so much she feels it might “explode.”   The husband tells you that she has no health problems and takes no medications other than aspirin for occasional pain. He also tells you that she entered a contest earlier today to try and drink the most water in 1 hour. She drank 10 glasses but did not win the contest and came home. Her confusion and headache started about an hour later.

What type of fluid or electrolyte imbalance is she likely to have and from what cause? Explain your answer.

What physical assessment data are the priority to obtain? Explain.

What laboratory data would you expect to be ordered?

Is this patient at risk for heart failure or pulmonary edema? Why or why not?

Answer 1

Drinking water in excess quantity than the required amount or than the kidney's capability to excrete it .Also drinking it in a short period of time can make an individual critical in a very short time.When water is taken ,dilution happens in blood ,this leads to decreased sodium level (hyponatremia ) and this is called as water intoxication

The priority physical assessment data are

• Mental status examination for consciousnes,alertness,disorientation, headaches ,convulsion because decrease in sodium alters the function of brain
• Monitor patients vital signs (blood pressure, pulse,respiration ) alterations occurs in this at first
• Observe for swelling at knee,ankle and foot ,moist or warm skin,pitting edema
• Payient may have hyperventilation
• Wright gain

The patient has to under go blood test and urine test

Blood test :serum electrolytes (especially sodoum)

Serum osmolality test to assess sodium level

CBC:decreased hematocrit level

BUN:decreased level

Urine test to assess the gravity,colour, any electrolytes

The patient is at incresed risk of getting heart failure due to excess fluid and the hearts functions to pump more causing overload. Pulmonary enema is not common but pulmonary effusion occurs in water intoxication