A 5 year old child is brought in to your ED by her mum. The mum states that the child has not been herself for the last 2 weeks. She is lethargic and has not been as active as normal.

On examination she is looks unwell

BP 75/55

PR 125/min

RR 26/min

Her blood results are as follows:

Na 130 mmol/l  (133-143)

K  5.5  mmol/l   (35-5)

Cl  102 mmol/l  (99-111)

HCO3  15  mmol/l   (22-26)

Urea  8.5  mmol/l  (5-8)

Creatinine  100  umo/l   (40-100)

Questions:

1. What are your emergent priorites in his treatment?

2. Describe the abnormalities

3. What is the likely cause?

4. What are the precipitants?

5. What clinical features would assist in your diagnosis?

6. What would you do next?