Question

PATIENT A–Presented in the emergency department with severe headache, irritability, and tremors after finishing a full marathon. Laboratory values reveal Serum sodium level of 130 mEq/L.

PATIENT B–Presented in the emergency department with severe body malaise, diminished bowel sounds, and ECG reveals an extra U-wave in the tracing after 8 bouts of watery diarrhea. Laboratory values further reveal a Serum potassium level of 3.0 mEq/L.

PATIENT C–A post thyroidectomy patient presented with severe muscle cramps and prolongation of QT-interval in the ECG and was referred to the medical consultant for co-management. Serum calcium level is 4.0 mEq/L.

PATIENT D–A patient receiving magnesium for the management of seizure disorder suddenly presented with depressed deep tendon reflex and becomes stuporous. Laboratory values reveal a Serum Magnesium level of 2.6 mg/dL.

Given the Patient B’s presentation, trace the pathophysiological cause of the decrease in serum potassium level.

What will be the emergency medication that should be readily available in managing the disorder apparent for Patient D?
Explain the relationship of thyroid surgery and the development of hypocalcemia in Patient C.
Explain the relationship of Patient A’s prior activity and the development of hyponatremia.
Explain the mechanism behind the development of prolonged QT –interval for Patient C.
Enumerate at least one (1) nursing diagnosis for Patient A, B, C, and D.

Answer 1

Severe diarrhea cause electrolyte loss. hypopotassemia causes the symptoms of muscle cramps, weakness, fatigue and abnormal heart rhythm when there is low potassium in the blood.
Patient having hypermagnesemia that cause the patient presented with the symptoms of deep tendon reflex and stuporous. calcium gluconate is a antitode for magnesium sulfate toxicity.
Hypocalcemia is a major complication after thyroid surgery. secondary hypoparathyroidism is a primary cause of thyroidectomy due to revascularization of one or more parathyroid glands during surgery..
Full marathon runners drink more water cause increase in total body water in the days or hours it causes more hyponatremia. it decreases sodium level in the body when they do more activity.