Assignment task:
Reply to the discussion. R. W. has type 1 diabetes, which has been poorly controlled for a long time; he has developed diseases such as chronic kidney disease and hypertension (Kalantar-Zadeh et al., 2021). A1C has persisted at a high level, and thus, she has developed renal damage manifested by high BUN (143 mg/dl), creatinine ((2.38 mg/dl), and reduced GFR (30 ml/min / 1.73 m2) showing stage 3 CKD. The sodium, potassium, chloride, and phosphate levels are high. In contrast, the serum levels of sodium, potassium, chloride, and phosphate were 149 mEq/L, 5. 4 mEq/L, 116 mEq/L, and 5. 9 mg/dL, respectively, all of which are because of the reduced renal capacity in this patient. The presented fatigue, weakness, dizziness, and itching correspond to a uremic state, which is among the severe complications of renal failure. This clinical sign indicates hypocalcemia status, coupled with the positive Chvostek sign, and agrees with the patient's low calcium levels of 6. 7 mg/dl. This can lead to muscle twitching and cramps, which fits her condition descriptions (Nielsen et al., 2020). Her blood pressure of 150/90 mmHg, though within normal range, and the presence of peripheral edema illustrate fluid retention is not well handled