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Question
i have apatient 7m ,7.750kg,66cm ith vsd,subaortic-small but with severe pht,presented with tachypnea,hypoxia,cxr reveal diffuse small round opacity,fever,cefotamim,ampiclox,garamycin iweek no responce vancomycin started,4 days no resoonce,hypotention metabolic alkalosis,hypokalemia,teatment accodigly refadin stared,last day last day investication reveal hb6g/l,retic 1.5% bu 70g/l/,cr.9.na 115,ca 6,k3.5,tp4.6,alb4.2.sgpt40,sgot70 fever subsid,hypoxia improve we put a dx of resistant staph aureous any openion

Answer
The child's sodium is very low. It may be due to the diuretics that the child may be prescribed. The hyponatremia needs to be corrected. Also regarding the Xray findings, it could be due to pulmonary edema or due to infection.
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