19 year old female college student who is pledging sorority arrives at the Emergency Department after participating in a contest to drink the most water.  She drank 5 liters of water in about 2 hours.  The sorority sisters called 911 and the student reported a headache and was confused.  Upon arrival to the ED, a nursing assessment was performed and lab tests ordered by the MD were obtained.  The patient reports a headache, abdominal cramping and has Orthostatic hypotension.  The following Lab results were reported.

Sodium – 122mEq/L, Potassium 3.6mEq/L, Calcium 10mg/dl, Magnesium 2mg/Dl, Chloride 100mEq/L, Phosphate 2mEq/L.

Cluster and analyze the data in the scenario.

Determine the electrolyte imbalance.

As the RN monitoring the patient, what assessment will you perform for early recognition of potential problems?  Identify a Nursing diagnosis with related factors, and defining characteristics (if apppropriate).  Describe the analysis used and rationale for your choice.