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Review Question - QID 212859

Electrolyte Disturbances Potassium Electrolyte Disturbances Hyponatremia Hypernatremia Definition serum sodium of < 135 mmol/L Etiology pseudohyponatremia hyperglycemia hyperlipidemia hypervolemic hyponatremia congestive heart failure nephrotic syndrome cirrh QID: 212859 (M2.OMB.19.4837)
In scope icon M 6 B
QID 212859 (Type "212859" in App Search)
A 27-year-old man presents to his primary care physician after a recent illness. For the past 48 hours the patient has experienced constant vomiting and diarrhea with a high fever. He is feeling better today and wants to be seen to ensure he is healthy. The patient has a past medical history of schizophrenia well controlled with risperidone and lithium. He takes ibuprofen for knee pain and attempts to stay well hydrated. Laboratory values are ordered as seen below.

Serum:
Na+: 123 mEq/L
Cl-: 90 mEq/L
K+: 3.8 mEq/L
HCO3-: 29 mEq/L
BUN: 42 mg/dL
Glucose: 109 mg/dL
Creatinine: 1.9 mg/dL
Ca2+: 10.2 mg/dL

Which of the following is the most likely explanation for this patient’s laboratory derangements?
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