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A middle aged male presents who works as a painter and is found obtunded at work. He has a negative head CT, negative urine toxicology, negative ethanol and the following lab values: Na 138 mEq/L, K 5.2 mEq/L, Cl 101 mEq/L, HCO3 12 mEq/L, BUN 15 mg/dL, Creatinine 1.1 mg/dL, Glucose 96 mg/dL, ABG: PO2 89, PCO2 26, pH 7.19. What diagnostic test should be ordered?

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