Electrolyte Imbalance and Patient Symptoms

A 65-year-old patient with a history of heart failure is admitted to the hospital with pulmonary edema and weight gain of 6 pounds over the past week. Lab results indicate the following electrolyte levels: Sodium 130 mEq/L, Potassium 4.2 mEq/L, Chloride 95 mEq/L, and Magnesium 1.8 mEq/L. The healthcare provider orders fluid restrictions and diuretics. During your assessment, you note the patient exhibits muscle cramps and has a decreased level of consciousness. Which of the following electrolyte imbalances is most likely contributing to this patient's symptoms?