Electrolyte disturbances Quiz: Ace Your Exams

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A 27-year-old female is admitted to the hospital with suicidal ideation. Today is the fourth day of hospitalization, and the course has been uncomplicated. The patient has been participating in therapy, taking medications, and eating daily. During rounds, the patient is noted to have altered mental status. Temperature is 37.0°C (98.6°F), pulse is 76/min, respirations are 22/min, blood pressure is 102/74 mmHg, and BMI is 17 kg/m2. On physical exam, the patient appears thin and cachectic with several healing lacerations noted over the volar aspect of the wrists. Multiple calluses are present over the knuckles of the right hand. She has 2+ pitting edema in the lower extremities bilaterally and faint bibasilar rales on pulmonary auscultation. She is having intermittent convulsions in the upper and lower extremities bilaterally. Which of the following electrolyte abnormalities is most likely present?  

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