21-year old woman that has had type 1 diabetes for the past 8 years, was brought to the hospital in a coma. She was prescribed to take 92 units of insulin a day to maintain her sugar levels within normal limits and prevent excess sugar in her urine. Upon admission she was hypontensive, tachycardic and hyperventilating. Her labs show she is acidonic, arterial blood carbon dioxide levels were low, blood oxygen tension is normal, bicarbonate levels are really low indicating metabolic acidosis, low sodium levels, slightly high level of potassium, Chloride level is on the low end of normal, very high levels of blood urea and nitrogen, total carbon dioxide levels are really low, extremely high sugar…
Mr. M, 52, comes to the ED complaining of intermittent palpitations, shortness of breath, and lightheadedness. Triage takes Mr. M back into the treatment area after a quick evaluation. His vital signs are BP, 140/80; pulse, 148 and regular; respirations, 18; and SpO2, 97% on room air.…
so by her oximetry and perfusion status review. As such the following would be the initial…
What are some of the specific health problems that can arise from an imbalance of electrolytes in the body?…
Clinical Application Questions Shanti Sharma RNSG 1413 May 25, 2018 Chapter 41: Fluid and ElectrolytesMrs. Hilda Beck is a 72-year-old seen by her health care provider this morning after falling at home because she became light-headed after vomiting and having diarrhea that has lasted over 24 hours. She was admitted for oral and intravenous (IV) fluid therapy. 1.…
Fluid Volume Deficit (Hypo-Volemia): shift from plasma into ICF with sodium loss, treat with isotonic fluids, blood products for blood loss, low BP, increase HR, weak thready pulse, no JVD, increase RR, decreased LOC, cool skin POOR SKIN TURGOR…
cardiac monitoring, k+ monitoring, monitor breathing and circulation. IV administration of calcium gluconate, glucose, and insulin, if ineffective possible dialysis (hemodialysis or peritoneal) Diuretics to assist with excretion of excess K+. Education regarding foods and complications ect. Assess patients understanding of appropriate salt substitutes and potassium replacements. Counseling for possible…
Report ABNORMAL assessment findings to the physician immediately, such as; cardiovascular status, respiratory status, kidney function, neurologic status, musculoskeletal status, nutritional status, skin appearance and psychosocial abnormalities.…
Since the patient has become unresponsive the nurse should begin with a neurological assessment by checking pupils for reaction and using a blunt needle on the extremities to insure a response from both the autonomic and peripheral nervous system. The respiratory and cardiovascular system can be assessed with the use of a stethoscope by listening to lung and heart sounds, as well as, checking peripheral pulses, capillary refill time, and checking for any discoloration of the skin especially around the mouth and extremities. To conclude the assessment of the integumentary system the nurse should check for any abrasions, bruising, or wounds sustained by the patient during the fall the patient reported. The nurse can continue to assess the patient’s pain level by looking for key expressions that would indicate the patient is in pain such as furrowing brow, flared nostrils, grimacing, or restlessness at the point of at which external pain factors are used to determine responsiveness of the patient such as a sterna rub or pinching of the knuckles. The scenario indicates that the patient has begun to have increased difficulty with breathing at…
She was transferred to the long-term care section of the hospital. Vital signs are: BP 96/62; pulse: 99 to 122 beats per minute and irregular; respirations: 20 breaths per minute. Heart sounds are irregular and distant; peripheral pulses are very weak; dorsalis pedis pulse is present in…
. I expect that following 8 hours shift the patient or caregiver will explain actions and precautions to take for orthostatic hypotension. The patient will not sustain fall during 8 hours shift. I anticipate that the patient and her caregiver will implement strategies to increase safety and prevent falls at home. I predict that the pain is will be reduced/ and lost the spasms will be controlled at the end of 8 hours shift . I presume that the patient will report decrease of urgency with urination within 3days. Also, I anticipate a decreasing occurrence of the dyshrthmia ( by decreasing contributory factors) to maintain cardiac output during my 8 hours shift and at the same time I assume minimize anxiety acquiring knowledge of dysrhytmia incorporing coping mechanism at home…
Mr. Debourg is 62 year old male. In 2013, during routine physical with his physician, he was referred to a cardiologist for further evaluation. Patient was diagnosed with high blood pressure and started on Lisinopril 10mg daily. Due to stress from work, he started having palpitation and shortness of breath. On 4/13/2014, patient started feeling hot and dizzy. When his wife noticed patient’s face was turning pale, she took his blood pressure. Patient states he’s blood pressure at that time was around 200/100, heart rate above 150. Mr. DeBourg drove himself to the hospital where he was admitted for further evaluation and tests. Angiogram showed 2 blocked arteries and he received Cardiac stent placement. Patient is now on 4 blood pressure medications and sees cardiologist…
Mrs. Greenway is exhibiting symptoms of dehydration due to diarrhea. Based on the data available it is important to do her nutritional assessment of last few days to figure out the reason of severe diarrhea (Knight, Kais, Santaolalla, & Abreu, 2015). This may be helpful in determining certain types of food that causes flare ups and plan particular diet excluding those food items (Knight et al, 2015). It is important to cure acute diarrhea to prevent additional electrolyte imbalance. Whether she is taking adequate fluids is another equally important question to ask. Information on intake and output and weight gain the client of fluid is important to assess the severity of dehydration to start intravenous fluid administration to prevent hypovolemia…
Assessed for presence of edema, I & Os, lab values of sodium and potassium, vital signs performed q hour, breath sounds assessed, cardiac monitoring.…
As evidence by: Redness on coccyx area (around 2cm), redness on perineum and auxiliary area…