A 30-year-old woman presents with severe sunburn that she received from using a tanning bed. She tells you that she feels terrible and has been vomiting all morning. She also complains of feeling dizzy. All of her skin, except for the skin beneath her bikini top and bottom areas, are burned. Consider what effects a severe sunburn might have on this woman’s fluid and electrolyte balance. Be as specific as you can.

A 2-year-old child is brought into the urgent treatment clinic with persistent fever, vomiting, and diarrhea. Consider the type of fluid and electrolyte losses this child is at risk for developing. Be specific about fluids lost through fever, vomiting, and diarrhea. What other clinical manifestations of fluid and electrolyte imbalances will you need to watch for?

A 92-year-old nursing home patient is brought into the emergency department with hyperosmolar hyperglycemic nonketotic coma (HHNC). Her fluid and electrolyte imbalances are at a critical level. Consider the types of fluid and electrolyte imbalances she may have, and what kinds of clinical manifestations due to these imbalances that you are likely to see.