An 83 y/o woman with history of hypertension, prior stroke, and Alzheimer's dementia (height 5’6”, usual weight 142 lbs)

[answerhappygod]

An 83 y/o woman with history of hypertension, prior stroke, and
Alzheimer's dementia (height 5’6”, usual weight 142 lbs) who lives
in a nursing home had progressively worsening confusion and
weakness over the past few days. She was in her usual state of
health until 5 days ago when she developed cough and nasal
congestion. She did not complain of fever but had a progressive
loss of appetite. She continued to take her medications until
yesterday (lisinopril, furosemide, simvastatin). when the nurse
went to check on her this morning, she was more confused and
disoriented than usual. She was transferred to the hospital via
ambulance.
PHYSICAL EXAMINATION:
LABORATORY DATA:
QUESTIONS:
After initial fluid resuscitation, the patient’s vital signs
were: BP 110/62 mmHg (lying); HR 102 bpm; RR 18 bpm. Repeat
laboratory data: serum Na 161 mEq/L, serum K 2.9 mEq/L, serum Cl
118 mEq/L, CO2 32 mEq/L, BUN 51 mg/dL, serum Cr 2.3 mg/dL, glucose
110 mg/dL
QUESTIONS: