Your patient is admitted with 3 day h/o vomitting and diarrhea. She is hypovolemic, hypotensive, tachycardic, and has decreased UOP. Her labs show an elevated HCT, sodium of 130, Cl- level of 90 (nl is 97-105), she has a bicarb of 17, pH of 7.32, CO2 33, and urine spec gravity is < 1.010. What is her diagnosis and how would you treat it?
She is in an isotonic hypovolemic state with hyponatremia, hypochloremia, metabolic alkalosis. She needs IVF replacement with hypertonic 0.9 NS until her sodium returns to normal, NPO, possibly give her bicarb suppliment. All this while taking care not to increase her sodium level too quickly.