emergency medicine
63-year-old woman brought to an ED after being found in a stairwell on Monday morning, last seen Friday afternoon
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A 19-year-old woman has a witnessed seizure at a rave party. On arrival of emergency medical services, the patient was postictal and only responsive to painful stimuli. Her friends state that she had been using recreational drugs prior to collapsing.
On presentation, she has another generalized tonic clonic seizure that lasts 30 seconds, and she responds to 2 mg lorazepam.
Her vitals signs are the following:
Temperature (oral): 99°F
Heart rate: 120 beats/minute
Blood pressure: 130/80 mm Hg
Respiratory rate: 20 breaths/minute
Oxygen: 95% saturation on 2 L nasal cannula
Other findings are as follows:
Fingerstick glucose: 90 mg/dL
Mental status: Postictal, moans to pain
Pupils: 5-6 mm, sluggish
Moist mucous membranes
Skin: Diaphoretic
Hyperactive bowel sounds
2+ clonus bilateral ankles
Electrocardiography reveals sinus tachycardia with narrow complexes.
What electrolyte abnormality should be considered?
- hyponatremia
- hyperkalemia
- hypocalcemia
- hypercalcemia
- hypernatremia
This question appears in Med-Challenger Emergency Nurse Practitioner Exam Review with CME
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