A 61 year old male banker Tom Jones was in good health until he lost control of his car hit a light pole and suffered head

Question

A 61 year old male banker Tom Jones was in good health until he lost control of his car hit a light pole and suffered head trauma While hospitalized in the intensive care unit ICU during recovery he developed hospital acquired pneumonia During his long hospitalization Tom began to show signs of depression and was treated with a selective serotonin reuptake inhibitor His depression was not lessened in 2 weeks and the dosage of the antidepressant was increased Six days after his dosage increase his nurse noted the patient exhibited confusion and lethargy Tom s blood pressure was slightly elevated His chemistries showed the following BUN 9 mg dL Nat 121 mEq L Cl mEq L Serum uric acid 2 2 mg dL decreased The remaining electrolytes and chemistry panel tests were within normal limits Thyroid tests and cortisol test Normal Tom s physician then ordered a serum and a urine osmolarity and urine sodium level He was started on a water restriction regimen and was given a saline IV and saline PEG tube flushes were begun The serum osmolarity was low while the urine osmolarity and urine sodium were elevated Questions 1 What condition has hypotonic plasma with lower serum osmolarity and higher urine osmolarity and an elevated urine sodium and the plasma sodium observed above 2pts 2 What OTHER disorder is associated with ADH 1pt 3 What is the serum sodium reference range Include units 1pt 4 How does ADH affect the body 1pt

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