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Practice Case Studies

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Practice Case Studies
Chapter 6 –

Case Study 1
Mr. E., age 53, has a history of alcoholism and came to his physician because of recent anorexia, nausea, and diarrhea, as well as heart palpitations and fatigue. He has been taking his diuretic tablet, but not his vitamin and mineral supplement. An ECG and blood tests indicate hypokalemia.

Discussion Questions
1. Discuss the possible factors contributing to his electrolyte imbalance and the rationale for his signs and symptoms.
2. What are the signs of hypokalemia and why is it important to identify potassium imbalances quickly?
3. What is the role of potassium in cardiac function?

Case Study 2
Ms. R. is a 65-year-old female who spends most of her day sitting on her porch and recovering from a recent surgery involving the removal of suspected cancerous lymph glands in the inguinal area. She is now complaining that her shoes are fitting too tightly, and she has developed poorly healing sores on her legs and ankles. A closer examination also shows distention in her varicose veins. Blood tests reveal a low level of proteins in the plasma.

Discussion Questions
1. Based on the patient history and the signs and symptoms, identify the fluid imbalance the patient is experiencing with rationale. (See: Edema)
2. Discuss the four general causes of edema and how they apply in the case of this specific patient. (See: Causes of Edema)
3. Discuss the swelling, sores, varicose vein distention, and other effects that edema can have on a patient. (See: Effects of Edema)

Case Study 3
Kirsten, a 3-month-old infant, has begun to have frequent loose stools that progress to a watery diarrhea. She is unresponsive, with dry mucous membranes; sunken fontanelles; and little, if any, urine output. Respirations are rapid and the heart rate is elevated.

Discussion Questions
1. What acid-base imbalance is Kirsten experiencing, and how is this affecting her ability to compensate?
2. What is the cause of oliguria, and how does this complicate the situation?
3.

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