A 19-year-old female college student who is pledging a sorority arrives at the Emergency Department (ED) after participating in a contest to drink the most water. She drank 5 liters of water in about 2 hours. The sorority sisters called 911 when the student reported a headache and was confused. Upon arrival to the ED, a nursing assessment was performed and laboratory tests ordered by the MD were obtained. The patient reports a headache, abdominal cramping, has poor skin turgor, dry mucous membranes, and orthostatic hypotension. The following laboratory results are reported:

Sodium: 122 mEq/L

Potassium: 3.6 mEq/L

Calcium: 10 mg/dL

Magnesium: 2 mg/dL

Chloride: 100 mEq/L

Phosphate: 2 mEq/L

IV therapy is initiated according to the MD order.

Initial Discussion Post:

Cluster and analyze the data in the scenario. Determine the electrolyte imbalance.

• As the RN monitoring this patient, what assessments will you perform for early recognition of potential problems? Identify a nursing diagnosis with related factors, and defining characteristics (if appropriate).
• Describe the analysis used and rationale for your choice.