An elderly patient has been having copious vomiting for several days and has become lethargic and weak. His mucous membranes are dry. He has poor skin turgor. Lab work shows: sodium of 145, ABGs: pH 7.58, PCO2 38, HCO3 38, PO2 95, SO2 98. Which response best explains the patient’s lethargy and weakness?
The hypokalemia brought on severe muscle spasms, causing exhaustion.
Due to his low potassium, his cells rely on glycolysis.
Due to the hypokalemia, his cells are hyperpolarized.
The hypernatremia caused cellular dehydration, leading to lethargy.
The Correct Answer is D
Choice A rationale
Hypokalemia can cause muscle weakness and cramps, but it does not typically lead to severe muscle spasms causing exhaustion. The patient’s symptoms of lethargy and weakness are more likely related to electrolyte imbalances and dehydration rather than muscle spasms.
Choice B rationale
While low potassium levels can affect cellular metabolism, the primary issue here is not glycolysis. The patient’s symptoms are more consistent with dehydration and electrolyte imbalances rather than a metabolic shift to glycolysis.
Choice C rationale
Hypokalemia can cause cells to become hyperpolarized, leading to muscle weakness and decreased reflexes. However, the patient’s symptoms of lethargy and weakness are more likely due to dehydration and electrolyte imbalances rather than cellular hyperpolarization.
Choice D rationale
Hypernatremia, or high sodium levels, can cause cellular dehydration, leading to symptoms such as lethargy and weakness. The patient’s lab results and clinical presentation are consistent with hypernatremia-induced cellular dehydration, which explains his symptoms.
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Correct Answer is A
Explanation
Choice A rationale
A hypertensive crisis is characterized by severely elevated blood pressure, which can cause severe headache and blurred vision due to increased intracranial pressure.
Choice B rationale
Migraines can cause severe headaches and visual disturbances, but in a patient with a history of hypertension, a hypertensive crisis is more likely.
Choice C rationale
Sinus infections can cause headaches and facial pain, but not typically blurred vision.
Choice D rationale
Gastroenteritis causes gastrointestinal symptoms like diarrhea and vomiting, not headaches and blurred vision.
Correct Answer is A
Explanation
Choice A rationale
It takes about 14 days to develop antibodies and immunity to the disease after vaccine administration. This is why the patient is asked to return in 2 to 3 weeks for an antibody titer. The immune system needs time to respond to the vaccine and produce detectable levels of antibodies.
Choice B rationale
The laboratory running out of blood specimen tubes is not a valid reason for delaying the antibody titer. This choice does not provide an accurate explanation for the patient.
Choice C rationale
It takes about 14 days to develop antibodies, not antigens, and immunity to the disease after vaccine administration. This choice contains incorrect information about the immune response.
Choice D rationale
After receiving the vaccine, the patient is not likely to transmit the communicable disease to the laboratory. This choice does not provide a valid reason for delaying the antibody titer.