The NP received a urgent consult request for a 52 year old women with
Question The NP received a urgent consult request for a 52 year old women withend stage renal disease. The patient is in the endoscopy area undergoing a colonoscopy for renal transplant evaluation. While awaiting the colonoscopy to being, the patient is noted to have weakness, irritability and is obtunded. She does not arouse to her name but responds appropriate to painful stimuli. Her breathing appears labored and her muscles are very flaccid. The patient’s son indicated that there is nothing new or different with the patient over the last day except two bottles of Citromag (magnesium citrate) as part of the bowel prep for the colonscopy.Past medical history – end stage renal disease, hypertension, anemia.No drug clergiesCurrent medications include metoprolol, lisinopril, sevelamer, cinacalcet, and Aranesp given at dialysis.Physical exam – patient is essentially unresponsive. BP 91/35 HR 44 RR 6Rest of the exam is essentially normal except for nearly absent deep tendon reflexes.Emergency labs completed show:-Sodium 134-Potassium 5.1-Chloride 101-Bicarbonate 21-BUN 67-Creatinine 9.9-Glucose 101-Calcium 7.9-Magnesium 5.6What is your working diagnosis? How would you treat this patient? Health Science Science Nursing NRNP 6566 Share QuestionEmailCopy link Comments (0)
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