Question

1. Mrs. Dean is a 75-year-old woman admitted to the hospital for a small bowel obstruction. Her medical history includes hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low continuous suction. She has an IV of 0.9% NS at 83 mL/hr. Current medications include furosemide, 20 mg daily and hydromorphone, 0.2 mg every 4 hours, as needed for pain. The morning electrolytes reveal serum potassium of 3.2 mEq/L. (Learning Objective 4) a. What are possible causes of a low potassium level? b. What action should the nurse take in relation to the serum potassium level? c. What clinical manifestations might the nurse assess in Mrs. Dean? 2. Conrad Jackson is a 28-year-old man who presents to the emergency department with severe fatigue and dehydration secondary to a 4-day history of vomiting. During the interview, he describes attending a family reunion and states that perhaps he "ate something bad." Upon admission his vital signs are a temperature of 102.7°F, heart rate of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The nurse also notes the patient has dry mucous membranes and tenting of skin. The physician orders an to be started with 0.45% normal saline, and orders a serum electrolyte and an arterial blood gas. (Learning Objective 7) The following results are returned from the laboratory: Sodium (Na+) Potassium (K+) Chloride (CI) BUN Creatinine Glucose pH PaCO2 HCO3 PaO2 O2 Sat 150 5.5 110 42 0.8 86 7.32 35 20 90 9896

Answer 1

1:a)Furosemide is a loop diuretic,which has an effect to decrease the potassium level as there are high chances of electrolyte imbalance when this drug is administered

b)The nurse should do the following

• Inform the report go the duty doctor
• Administer IV potassium as per order diluted in IV fluids

c)The following clinical manifestation can be assessed in the patient

• Weakness
• Muscle spasm
• Digestive problems though NPO like triggering nausea and vomiting ,abdominal cramping, bloating
• Mood swings
• Numbness or tingling sensation
• Assess vital signs for breathing difficulty