Question

Case Study 2 A 65 year old female is admitt hydrochlorothiazide. She relates ole is admitted to your unit complaining of nausea, vomitinand istory is unremarkable except hypertension for which she takes diarrhea for 3 days. Her history is unremarkable eye de She relates feeling exhausted and having leg cramps which interfere ssessment findings include T. 101.5 F, AP 102 and irregular, heb her sleeping. Notable assessment findings include T1 sounds, poor muscle tone and skin turgor. Laboratory data P90/50: absent bowel sounds, poor muscle tone and skin w a Na+ 137 mEq/L, CI-97 mEq/L, and WBC 20.000/L ECG shows includes K+ 2.9 mEq/L, Na+ 137 m cardiac arrhythmias (frequent PVCs) Physician's orders include: n's orders include: IV D50.9%NaCl with 20 mEq KCVL to infuse at 90cc/hr40 FKCL IV over the next 2 hours K+ level 30 minutes after 40 mEq IV KCl has infused. TV Bedrest: May use bathroom NPO 1. What fluid and/or electrolyte disturbances does this client have? 2. Which electrolyte disturbance is of most concern with this client? 3. Underline the signs and symptoms that can result from this electrolyte disturbance? 4. What do you suspect as the cause(s) of this electrolyte disturbance? What type of solution is DSNS with 20mEq KCI/L? 6. Would you question any of these orders? Why?

Answer 1

6)yes I would question the orders because hypertonic IV solution when person is suffering from hypovolemia is isotopic and also K+ electrolyte is administered high in quantity in 2 hours and orders did not explain how much quantity to dilute in K+

Recanice This client have hypokalemia, hypovolemia. Hypokalemia :- low potassium Hypovolemia :- blood plasma liquid portion is low @ Hypokalemia Potassium electrolyte disturbance is of most concern with this cliente Vomtinge, use she is suffering from diagonhea for 3 days this causes depletion of potassium in body * Signs & Symptoms include, Weakness, leg cramps, skin turgor, AP 102 and irregular, absent bowel tones, poor muscle tone and skin turgor, exhaustion- @ The electrolyte distribance cause is because Of vomtings, no kt replacement, 20 mEq kelle is a hypeatonic solution. Greater cons of solutes on the outer side of cell than inside of cello