ELECTROLYTE IMBALANCES
Assignment:
Several patients were admitted in the medical ward. Answer the
following
questions pertinent to the patients’ conditions.
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.
1. Given the Patient B’s presentation, trace the
pathophysiological cause of the
decrease in serum potassium level.
2. What will be the emergency medication that should be
readily available in
managing the disorder apparent for Patient D?
3. Explain the relationship of thyroid surgery and the
development of
hypocalcemia in Patient C.
4. Explain the relationship of Patient A’s prior activity and
the development of
hyponatremia.
5. Explain the mechanism behind the development of prolonged
QT – interval
for Patient C.
6. Enumerate at least one (1) nursing diagnosis for Patient A,
B, C, and D.
2. ACID-BASE IMBALANCES
Assignment:
Multitude of patient’s conditions can predispose them to
different acid-base
imbalances. Several patients were admitted in the
medical-surgical ward and are
put under your care. Answer the following questions pertinent
to the patients’
conditions.
PATIENT A – admitted in the medical ward 30 minutes ago with
chief complaint
of severe dizziness and vertigo accompanied by frequent
vomiting. As the patient
moves, vomiting follows which is now recorded to be 7-8 times
from the time of
admission. Diphenhydramine 1 ampule TIV and metoclopramide 1
ampule TIV
as stat doses were given to the patient.
PATIENT B – a dialysis patient who have stopped attending his
dialysis session
was admitted in the ward due to changes in sensorium. Serum
creatinine level is
elevated as well as the Blood Urea Nitrogen (BUN). Shallow
respiration is noted
upon the assessment of the patient.
PATIENT C – a patient was rushed to the emergency department
and later was
admitted to the ward with chief complaint of shortness of
breath, numbness and
tingling around mouth and fingers, and lightheadedness after
taking a major
examination in school. The patient was offered a brown bag by
the admitting
nurse.
PATIENT D – A patient with emphysema as admitted in the ward
due to difficulty
of breathing. The patient appears reddish and is complaining
of lightheadedness.
The patient was immediately hooked to oxygen therapy at 2
Lpm.
Choose from the following ABG results which will be consistent
with the patient’s
condition:
A. pH 7.50 PaC02 31 HCO3 17
B. pH 7.30 PaC02 30 HCO3 18
C. pH 7.48 PaC02 49 HCO3 30
D. pH 7.32 PaC02 50 HCO3 28
1. Patient A: __
2. Patient B: __
3. Patient C: __
4. Patient D: __
5. Explain why Patient B presented with shallow respiration in
relation to the
patient’s condition.
6. Explain why Patient D experiences lightheadedness and why
the patient
appears reddish in relation to the patient’s condition.
7. Explain the purpose of offering brown bag to Patient C as
an emergency
management for the patient’s condition.
8. Create a drug study for the medication: METOCLOPROMIDE
specifying the
following:
a. Drug classification
b. Mechanism of action
c. Indication (*for the case of the patient mentioned
above)
d. Contraindication
e. Side effects
f. Nursing Considerations