Electrolyte Imbalance and Clinical Question(?)

I have a question regarding a scenario that I just cannot seem to figure out completely. Could somebody help me? The patient is M, 50 y/o. NPO post abdominal surgery. IV D5RL @ 100cc/hr. IV stopped. Poor skin turgor and hypotensive. Large furrows on tongue.
Chem K-2.8 Na-132 CL-95 Urine gravity >1.025 Hemat- <50% BUN <25 Cap. refill 4 seconds. BP 90/60, P-125, R-32, Temp-100.9. IV is hurting. Urine is dark amber and has passed only 100cc within the last 8 hours.

My take is that he is hypckalemic w/dehydration. Also hypovolemic. This would be due to the IV stoppage -- the patient isn't getting the electrolyte-enhancing fluid. The IV is hurting because there is a blockage. The higher CL level indicates a possible acid-base imbalance but that is unknown due to the fact that no ABG's were ordered. The CL is probably related to the low Na.

Does this sound correct? If not, what am I missing? Thank you for your help!!
If CL is Chloride, its not high, its low. 95-105 (some use 108).He definitely needs some K...probably hypovolemic as you noted (BP, Urine spec grav, oliguria, etc.). Dehydration is related to hypovolemia, as well. Also, with a hypokal, you can become acidotic because hydrogen ions take the place of K and Calcium in the cells. That is your likely cause of acid-base imbalance.If this is a test question or something similar, sounds like he needs to be pounded with NS c 40K and/or given some NS and some PO and IV K+.

It's pertinent to know how long the IV has been stopped.

You're right....CL is low. Don't know why I said high. Anyhow, what (if any) is the significance of the IV stoppage and the IV hurting? Would that be due to a blockage, infiltrate??? I'm a bit stumped on that one. I'm also leaning toward renal failure? But the urine specific gravity seems to contraindicate that to some degree. **sigh**

Quote from WhisperaIt's pertinent to know how long the IV has been stopped.

Quote from sw122500You're right....CL is low. Don't know why I said high. Anyhow, what (if any) is the significance of the IV stoppage and the IV hurting? Would that be due to a blockage, infiltrate??? I'm a bit stumped on that one. I'm also leaning toward renal failure? But the urine specific gravity seems to contraindicate that to some degree. **sigh**

Quote from sw122500You're right....CL is low. Don't know why I said high. Anyhow, what (if any) is the significance of the IV stoppage and the IV hurting? Would that be due to a blockage, infiltrate??? I'm a bit stumped on that one. I'm also leaning toward renal failure? But the urine specific gravity seems to contraindicate that to some degree. **sigh**

This patient is very hypovolemic. The IV being infiltrated for how long is important because the patient is NPO so they haven't been getting any replacement for as long as the IV has been infiltrated. Also depending on the type of surgery, if it was an open belly you can estimate this patient lost around 1L every hour he was open so by the time he comes to the floor he is already behind. As others said he is probably pre-renal due to the hypovolemic shock. This patient needs IVF boluses and K riders.The urine specific gravity is elevated because of the decreased urine output. Remember the body is trying to conserve as much fluid as possible.

Quote from sw122500i have a question regarding a scenario that i just cannot seem to figure out completely. could somebody help me? the patient is m, 50 y/o. npo post abdominal surgery.what day post op iv d5rl @ 100cc/hr. iv stopped. why was the iv stopped and for how long? is the k in the iv?poor skin turgor and hypotensive. tachycardia = dehydrationlarge furrows on tongue. dehydrationchem k-2.8 na-132 cl-95 urine gravity >1.025 hemat- <50% bun <25 cap. refill 4 seconds. bp 90/60, p-125, r-32, temp-100.9. iv is hurting. urine is dark amber and has passed only 100cc within the last 8 hours. dehydration..... 30 cc of urine per hour is indicative of end organ perfusion.my take is that he is hypckalemic w/dehydration. also hypovolemic. your patient is severly dehydrated therefore he is hypovolemic causing electrolyte imbalances low urine output, furrowed tongue, poor skin turgor and acidosis and renal insufficiency this would be due to the iv stoppage --or the surgery itself and third space loss from the abd or......how long prior to or was patient ill or npo....what was the estimated blood loss......... the patient isn't getting the electrolyte-enhancing fluid. you said the ivf was d5rl......what is the electrolyte? how much potassium? the iv is hurting because there is a blockage. are you sure?is there potassium in the iv as that can cause burning....check the iv for patency. the higher cl level indicates a possible acid-base imbalance but that is unknown is it unknown? dehydration, renal insuff, fluid and electrolyte imbalance due to the fact that no abg's were ordered. the cl is probably related to the low na. does this sound correct? if not, what am i missing? thank you for your help!!

Couldn't they be septic- fever, low bp, tach, recent OR. Kidney's shutting down, poor circulation

Quote from bjaeramCouldn't they be septic- fever, low bp, tach, recent OR. Kidney's shutting down, poor circulation

I'd like to thank all of you for your assistance. <3