A patient has a serum sodium level of 145 mEq/L, serum chloride ...

[B]

A patient has a serum sodium level of 145 mEq/L, serum chloride level of 114 mEq/L, and serum bicarbonate level of 20 mEq/L. What should the nurse calculate as being this patient's anion gap?
 
  What will be an ideal response?

Question 2

A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient?
 
  Select all that apply.
  1. IV normal saline
  2. calcium-containing antacids
  3. IV potassium phosphate
  4. additional milk intake
  5. increased vitamin D intake

[verrinzo]

Answer to Question 1

Correct Answer: 11 mEq/L

The anion gap is calculated by subtracting the sum of two measured anions, chloride and bicarbonate, from the concentration of the major cation, sodium. For this patient the equation would be 145  (114 + 20) = 145  134 = 11 mEq/L.

Answer to Question 2

Correct Answer: 1, 2
Serum phosphate level of 4.7 mg/dL indicates hyperphosphatemia. IV normal saline promotes renal excretion of phosphate. Calcium-containing antacids bind the phosphate for excretion through the GI tract. IV potassium phosphate is a treatment for low phosphate. Milk is a high phosphate food and should be discouraged. Excess vitamin D increases phosphate absorption and can lead to hyperphosphatemia.

[B]

Thank you

[verrinzo]

Happy to help you